1/7. Four-level noncontiguous fracture of the vertebral column: a case report.The case of a patient with four-level fractures of the vertebral column, located at the cervical, thoracic, lumbar, and sacral regions, three of which were unstable, is reported. There were no injuries in the appendicular skeleton. Neurological involvement was potentially caused by multilevel compressions. This patient was treated aggressively with early surgical stabilization of all unstable levels, which facilitated early expeditious rehabilitation.- - - - - - - - - - ranking = 1keywords = fracture, compression (Clic here for more details about this article) |
2/7. Bilateral multiple cervical root avulsions without skeletal or ligamentous damage resulting from blast injury: case report.OBJECTIVE AND IMPORTANCE: We describe a unique case of multiple bilateral cervical root injuries without ligamentous or bony injury secondary to a sandblast accident. CLINICAL PRESENTATION: A 19-year-old man sustained a sandblast injury to his face, neck, chest, and upper extremities, with immediate loss of motor and sensory function occurring in both of his upper extremities. Cervical spine x-rays, computed tomography, and magnetic resonance imaging demonstrated no fracture, soft tissue abnormality, or malalignment. The restriction of deficits to the patient's upper extremities suggested a central cervical spinal cord injury, bilateral brachial injuries, or a conversion disorder. INTERVENTION: Cervical computed tomographic myelography revealed multiple bilateral nerve root injuries. CONCLUSION: This case report is unique in the literature in that it describes a patient with multiple cervical nerve root injuries secondary to sandblast injury without ligamentous or bony injury. Although magnetic resonance imaging remains the diagnostic modality of choice in patients with acute spinal cord injury, it is deficient in demonstrating cervical root injury in the acute setting. In this setting, computed tomographic myelography is superior.- - - - - - - - - - ranking = 0.19861239589237keywords = fracture (Clic here for more details about this article) |
3/7. Circumferential fracture of the skull base causing craniocervical dislocation. Case report.Fractures of the craniocervical junction are common in victims of high-speed motor vehicle accidents; indeed, injury to this area is often fatal. The authors present the unusual case of a young woman who sustained a circumferential fracture of the craniocervical junction. Despite significant trauma to this area, she suffered remarkably minor neurological impairment and made an excellent recovery. Her injuries, treatment, and outcome, as well as a review of the literature with regard to injuries at the craniocervical junction, are discussed.- - - - - - - - - - ranking = 0.99306197946185keywords = fracture (Clic here for more details about this article) |
4/7. Injury to the deep branch of the ulnar nerve in association with dislocated fractures of metacarpals II-IV.The deep branch of the ulnar nerve may be injured at the same time as fracture dislocations of the fifth metacarpal. We describe injuries to that nerve in two patients with dislocated fractures of the second or third and fourth metacarpals. The fractures were treated by open reduction and fixation with plates and screws, and it is possible that the repositioning and fixing caused the injury.- - - - - - - - - - ranking = 1.3902867712466keywords = fracture (Clic here for more details about this article) |
5/7. Symptomatic cervical disc herniation in a pediatric Klippel-Feil patient: the risk of neural injury associated with extensive congenitally fused vertebrae and a hypermobile segment.STUDY DESIGN: A case report. OBJECTIVE: To report the occurrence of a herniated cervical disc following a high-impact activity in a pediatric Klippel-Feil patient who presented with spinal cord compression, myelopathy, and myelomalacia requiring posterior instrumented fusion followed by an anterior discectomy and fusion at the hypermobile nonfused segment. SUMMARY OF BACKGROUND DATA: The primary hallmark of klippel-feil syndrome (KFS) is the presence of at least one congenitally fused cervical segment. Studies have reported the potential risk of cervical injury from hypermobility associated with the nonfused cervical segment in KFS. The manifestation of a cervical disc herniation in the pediatric KFS patient is rare. To the authors' knowledge, the development of a symptomatic cervical herniated disc attributed to mechanical fatigue following a high-impact activity has not been addressed in the literature with respect to the pediatric KFS patient having extensive cervical fusion and a hypermobile segment. methods: A 16.8-year-old KFS boy with occipitalization of C1 and fusion of C2-C3 and C4-T1 presented with myelopathy, severe cord compression, and myelomalacia stemming from a left-sided herniated cervical disc at C3-C4 with onset following an 8-foot high rooftop jump. On radiographic evaluation, the patient's C3-C4 segment was hypermobile. RESULTS: The patient was operatively managed via a same-day combined posterior-anterior procedure. The posterior aspect of the procedure entailed a posterior lateral mass plate-screw fixation at C3-C4 with autologous iliac crest bone fusion. Anteriorly, a discectomy was performed at C3-C4 with application of an interbody tricortical autograft. After surgery, the patient wore a halo vest for 3 months, followed by a soft collar for an additional 3 months. On final follow-up at 39 months, the patient was asymptomatic with no instrumentation-related complications, fusion of the posterior graft-bed and anterior interbody graft was noted, and cervical alignment was maintained. CONCLUSIONS: A hypermobile segment in the pediatric KFS patient is a risk factor that may lead to cord compression. A symptomatic herniated cervical disc may develop from an excessive mechanical load stress in a pediatric KFS patient with multiple fused segments. In such a patient, a same-day combined posterior-anterior procedure provides cord decompression and stabilizes the spine with a favorable outcome.- - - - - - - - - - ranking = 0.027752082152586keywords = compression (Clic here for more details about this article) |
6/7. Fractures of the proximal tibial epiphysis.Fractures of the upper tibial epiphysis are rare. We report on three cases classified according to the Salter and Harris method. Case one, a Type III injury, was associated with a neurovascular lesion. Case two, a Type II injury, was associated with rupture of the medial collateral ligament of the knee, which was treated by internal fixation of the fracture and repair of the ligament. Case three was an unusual fracture, which has not previously been reported in the literature, a Type II injury with an accompanying fracture of the tibial tubercle.- - - - - - - - - - ranking = 0.59583718767711keywords = fracture (Clic here for more details about this article) |
7/7. Suprascapular nerve injury during spine surgery. A case report.In long spine surgeries, knee-chest position-associated complications can occur. This report describes a case of suprascapular nerve injury that occurred during the lengthy surgical procedure. It is postulated that excessive scapula, shoulder girdle, and upper arm protraction occurred, resulting in a sling effect compression injury of the suprascapular nerve.- - - - - - - - - - ranking = 0.0069380205381464keywords = compression (Clic here for more details about this article) |