scholarly journals Traumatic Posterior L4–L5 Fracture Dislocation of the Lumbar Spine: A Case Report

2012 ◽  
Vol 2 (4) ◽  
pp. 235-238 ◽  
Author(s):  
Baron Zarate-Kalfopulos ◽  
Samuel Romero-Vargas ◽  
Cesar Alcántara-Canseco ◽  
Luis Miguel Rosales-Olivarez ◽  
Armando Alpizar-Aguirre ◽  
...  
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Ct Scan ◽  
Vertebral Body ◽  
High Energy ◽  
Fracture Dislocation ◽  
X Rays ◽  
Lower Extremity Muscle ◽  
Lower Lumbar Spine ◽  
Muscle Groups

Study Design Case report. Objective The diagnosis and surgical management of a patient with traumatic bilateral posterior dislocation of L4–L5 is presented with a thorough review of the existing literature. Summary of Background Data Traumatic dislocation of L4–L5 has been reported in the English literature in only five cases; of these, only two were retrolisthesis. Methods A 20-year-old patient was involved in a high-energy vehicular accident and presented with back pain and inability to ambulate. Neurological assessment showed motor strength grade 2/5 in the proximal lower-extremity muscle groups (L1–L3 myotomes) and 0/5 strength distally (L4–S1 myotomes); in addition, incontinence of sphincters was found. X-rays and computed tomography (CT) scan revealed a three-column ligamentous injury with posterior fracture-dislocation of the L4 vertebral body with complete posterior displacement of L4 to L5 vertebral body. The patient underwent posterior approach with reduction, transpedicular fixation, and posterolateral fusion with autologous bone graft. Results At 1-year follow-up, the patient had recovered muscular strength in proximal lower-extremities muscle groups, sphincter function had fully recovered, and he was able to ambulate with crutches. There was no recovery of distal extremity sensorimotor function. Plain radiograph and CT scan showed good alignment and progressive maturation of his fusion procedure. Conclusion Traumatic retrolisthesis of L4–L5 is a high-energy unstable fracture; reduction of the dislocation is challenging because of the heavy forces acting in the lower lumbar spine. Instrumented fusion restores alignment and maintains segmental stability.

scholarly journals Rehabilitation Strategies in Management of Complex Case of Cervical Burst Fracture- A Case Report

2021 ◽  
pp. 205-208
Author(s):  
Rishika H. Gabada ◽  
Pooja Kasatwar ◽  
Chaitanya A. Kulkarni
Keyword(s):  
Ct Scan ◽  
Vertebral Body ◽  
Motor Vehicle ◽  
Burst Fracture ◽  
Compression Fracture ◽  
Complex Case ◽  
Fracture Dislocation ◽  
X Rays ◽  
Spinal Compression ◽  
Spinal Compression Fracture

A burst fracture is a descriptive term for an injury to the spine in which the vertebral body is severely compressed. They typically occur from severe trauma, such as a motor vehicle accident or a fall from a height. With a great deal of force vertically onto the spine, a vertebra may be crushed .If it is only crushed in the front part of the spine, it becomes wedge shaped and is called a compression fracture. However, if the vertebral body is crushed in all directions it is called a burst fracture. Burst fractures cause severe pain. The diagnosis of a burst fracture is usually made by x-rays and a CT scan. Occasionally, an MRI scan may be ordered as well, in order to assess the amount of soft tissue trauma, bleeding or ligament disruption. The review of the CT scan and x-rays allows the treating physician to make a determination as to the level of the fracture, whether it is a compression fracture, burst fracture or fracture dislocation. A spinal compression fracture also may be caused by trauma to the spine. Events that may cause trauma to the spine can include: A car accident, a hard fall or a fall from a height of more than 15 feet, landing on the feet, and a blow to the head. Any fall from a standing height that results in a spinal compression fracture or any other fracture most likely indicates weak bones due to osteoporosis. The physical exam should be performed to document both spinal deformity, that is, angulation of the spine or tenderness of the spine at the level of fracture, as well as, a neurologic exam. Neurologic exam should include testing of the muscle strength, sensation, and reflexes of the lower extremities, as well as, testing of bowel and bladder sphincter control. A 36 year old man was brought to the hospital as he had a fall from electric pole approximately 20 feet height. He had sustaining injury to the neck. Surgery was done as patient was diagnosed with C6 burst fracture with fracture dislocation of C5-C7. Therapeutic Interventions includes exercises, strengthening exercises, cervical fracture fixation, and traction.

Intra-articular Transcalcaneal Fracture-Dislocation Associated With Ipsilateral Transtalar Fracture: A Report of a Rare Combination

2020 ◽  
Vol 13 (4) ◽  
pp. 335-340
Author(s):  
Danilo Ryuko Cândido Nishikawa ◽  
Bruno Rodrigues de Miranda ◽  
Fernando Aires Duarte ◽  
Guilherme Honda Saito ◽  
Rogério Carneiro Bitar ◽  
...  
Keyword(s):  
Case Report ◽  
High Energy ◽  
Fracture Dislocation ◽  
Calcaneal Fractures ◽  
Short Term ◽  
High Energy Trauma ◽  
Rare Combination ◽  
Severe Bone Loss ◽  
Neck Fracture

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Residual deformities, multiple procedures, and limitations are usually the norm. Therefore, studies have suggested that primary arthrodesis may represent the best option of surgical treatment. In this study, we report a case of a 30-year-old male patient with a rare combination of a highly comminuted transcalcaneal fracture-dislocation associated with a talar neck fracture successfully treated with open reduction and internal fixation (ORIF) with an 18-month follow-up. This case demonstrates that even when there are associated fractures of the talus and calcaneus with severe bone loss, ORIF may provide satisfactory outcomes in the short-term postoperative period. Levels of Evidence: Level V: Case report

Fracture dislocation of the lumbar spine without paraplegia: A case report

1984 ◽  
Vol 55 (4) ◽  
pp. 466-468 ◽  
Author(s):  
Olavi Suomalainen ◽  
Matti Pääkkönen
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Fracture Dislocation

scholarly journals Stabilisation of Fractured Thoracic and Lumbar Spine with Cotrel-Dubousset Instrument

2003 ◽  
Vol 11 (1) ◽  
pp. 59-66 ◽  
Author(s):  
MS Moon ◽  
WT Choi ◽  
YW Moon ◽  
YS Kim ◽  
JL Moon
Keyword(s):  
Lumbar Spine ◽  
Vertebral Body ◽  
Posterolateral Fusion ◽  
Fracture Dislocation ◽  
Unstable Fracture ◽  
Fusion Construct ◽  
Screw Breakage ◽  
Group 2 ◽  
Group 1

Objective. To evaluate the effectiveness of 2 different types of Cotrel-Dubousset instrument systems in stabilising thoracolumbar and lumbar spine fractures. Methods. Between January 1989 and December 1993, 45 fractures in 42 patients with unstable fracture or fracture dislocation of the thoracolumbar and lumbar spines were randomly assigned to 2 surgical treatments with Cotrel-Dubousset instrumentation—using either a long segment (Group 1) or a short segment (Group 2)—and short posterolateral fusion. Results. Consolidation of the fractured vertebral body and posterolateral fusion were achieved at a mean time of 4.5 months; fusion rates were 75% in Group 1 and 83% in Group 2. The average collapses of anterior vertebral body height in Group 1, in the immediate postoperative period and at the final follow-up, were 15% and 17%, respectively; and in Group 2, the figures were 16% and 24%, respectively. The correction of vertebral height and kyphosis at the last follow-up were lost more in Group 2 (5.7°) than in Group 1 (4.4°). There were neurological recoveries in 6 of the 9 cases of incomplete paraplegics, including complete recovery in 5, and one-Frankel grade increase in one. There were 15 instrument failures in 12 patients, including screw breakage in 3 Group 1 cases and 6 Group 2 cases. The plug dislodged in 3 Group 1 cases, and the hook dislodged in 3 Group 2 cases. In other words, instrument failures were more common in Group 2. Conclusion. Cotrel-Dubousset stabilisation of the fractured spine achieves fracture consolidation, but does not maintain the restored height and sagittal curve completely until fusion. The long rod and short fusion construct was more effective for all fracture types than was the short rod and fusion construct, although it leads to wider immobilisation of normal segments.

scholarly journals A Rare Case of Complex Carpal Injury: Divergent Trapezium-Trapezoid Fracture Dislocation

2018 ◽  
Vol 10 (03) ◽  
pp. 150-154
Author(s):  
Bushu Harna ◽  
Dhananjaya Sabat
Keyword(s):  
Ct Scan ◽  
Road Traffic ◽  
Scaphoid Fracture ◽  
Fracture Morphology ◽  
Fracture Dislocation ◽  
Steering Wheel ◽  
X Rays ◽  
Computed Tomographic ◽  
Carpal Injury ◽  
K Wires

Abstract Background Divergent trapezium-trapezoid fracture dislocation is a rare and complex injury. The authors present an unusual case of dislocation of the trapezium-trapezoid complex with scaphoid fracture. Case Description A 25-year-old man suffered a road traffic accident leading to complex carpal injury due to axial and rotation forces (steer wheel injury) on the left wrist. X-rays and computed tomographic (CT) scan were done showing trapezium-trapezoid dissociation with fracture of distal pole of scaphoid and ulna styloid. The second metacarpal base was fractured with many ligamentous injuries in the wrist. Methods Volar flexor carpi radialis (FCR) approach was used to reduce and fix scaphoid fracture with 2.7-mm cannulated screw. Dorsal approach was used to fix fracture of second metacarpal base and perform reduction in trapezium-trapezoid complex with help of 0.8-mm K-wires, and suspension wiring of first to second and second to third metacarpal was done using 1.5-mm K-wires. The transverse flexor retinaculum (TFR) in this case was avulsed. Discussion The divergent trapezium-trapezoid joint with scaphoid fracture is not described in the literature yet. The authors implicate steering wheel injury pattern for such complex carpal fracture dislocations. CT scan is imperative to diagnose and plan treatment of such fracture morphology. Early fracture reduction and stabilization of carpal dislocations are essential for proper functioning of wrist.

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