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10-SEPTEMBER-2013  ALI SALEH MARZOOQ  52 YEARS  OLD FRACTURE DISLOCATION C4-5 AFTER RTA 6 MONTHS AGO.

 

Anamnesis

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The patient came to the clinic 07-September-2013 complaining of neck pain and inability to move the neck to all directions after suffering RTA in March-2013. The patient was treated for fracture ribs and heamothorax with UWS both sides and fracture left forearm was plated then after. The fracture dislocation of C4-5 was missed at that time.

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MRI of the cervical spine performed 03-September-2013  showing fracture dislocation of C4-5.

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On examination: the patient has limitation of neck movement with pain when looking to both sides and up and down. There is hypotrophy of the interossii left hand with weak grip and extension of the left hand 4/5 and triceps left 4/5.

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Using C-arm, the level of C4-5 identified. The upper edge of C5 was dislocated posterior more from the left side. Discectomy of C4-5 done with attempt for reduction. Samarys cervical cage 17x13x6 mm with bone graft was inserted to C4-5 disc space. Trestle 16 mm length cervical plate one level with 4 screws 14x4 mm were used to fuse C4 and C5. All stages were done under C-arm control.

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Smooth postoperative recovery. The power of the left upper limb became normal.

 

 

Comments

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The patient still having mobile fracture dislocation which needs surgical correction and fixation.

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Notice: Head injuries and very urgent surgeries are also escaped from the plan .

  

 

 

 

 

 

 

 

 

 

 

 

 

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