Bisegmental rotational fracture dislocation of the pediatric cervical spine. A case report

Spine (Phila Pa 1976). 1999 May 1;24(9):904-7. doi: 10.1097/00007632-199905010-00012.

Abstract

Study design: A case of a bisegmental rotational fracture dislocation in the pediatric cervical spine is presented.

Objectives: To highlight the problems in the diagnostics and surgical management of this rare type of injury.

Summary of background data: Fractures of the cervical spine are relatively uncommon in childhood. To the authors' knowledge, this is the first reported case of a bisegmental rotational fracture dislocation in the pediatric cervical spine managed by a combined anteroposterior approach.

Methods: A 6-year-old girl was hit by a car as a pedestrian. In addition to an open fracture dislocation of the Lisfranc joint in the right foot, she sustained a bisegmental fracture dislocation at the lower cervical spine (C3-C5) with no neurologic deficit. The complete diagnosis of a locked rotational fracture dislocation could be established only by using computed tomography scans with three-dimensional reconstructions. The injury was managed with a combined anteroposterior open reduction and a bisegmental anterior fusion.

Results: Implant removal was performed after bony fusion 6 months after surgery. At follow-up assessment 2.5 years later, the girl had a good radiologic result and a full and pain-free functional recovery.

Conclusions: Bisegmental rotational fracture dislocations in pediatric cervical spines are not easily diagnosed and may require three-dimensional computed tomography scan reconstructions for complete assessment. In such rare cases, a combined anteroposterior surgical procedure may be indicated, with a bisegmental anterior fusion providing a good functional result.

Publication types

  • Case Reports

MeSH terms

  • Bone Plates
  • Bone Screws
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / injuries*
  • Cervical Vertebrae / surgery
  • Child
  • Diskectomy
  • Female
  • Follow-Up Studies
  • Fractures, Open / diagnostic imaging*
  • Fractures, Open / surgery
  • Humans
  • Ilium / transplantation
  • Joint Dislocations / diagnostic imaging*
  • Joint Dislocations / surgery
  • Spinal Fractures / diagnostic imaging*
  • Spinal Fractures / surgery
  • Spinal Fusion / methods
  • Tomography, X-Ray Computed