Tsukamoto Masatsugu, Morimoto Tadatsugu, Kobayashi Takaomi, Hirata Hirohito, Yoshihara Tomohito, Mawatari Masaaki
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan.
BJR Case Rep. 2022 Nov 1;8(6):20220110. doi: 10.1259/bjrcr.20220110.
A 81-year-old female had chronic renal failure and was undergoing hemodialysis, visited orthopaedic clinic after striking her head on the ceiling of a car while driving on a rough road. An odontoid fracture went unidentified on the initial radiograph. One month later, she came to our hospital with persistent neck pain. A radiography and computed tomography revealed a C1-two subluxation secondary to the fracture. Posterior occipito-C1-C2-C3 fixation was performed, and the patient wore a halo-vest for two-month post-surgery. After two months, the halo-vest was removed, and the patient was not experiencing any pain or neurological deficits. In older patients, even minor head trauma can result in cervical vertebral fractures. Therefore, potential fractures should be considered during initial evaluations to avoid the serious consequences of an incorrect initial diagnosis. Care should be taken when choosing between conservative or surgical treatments, considering all potential risks and complications.
一名81岁女性患有慢性肾衰竭，正在接受血液透析，在崎岖道路上驾车时头部撞到汽车天花板后前往骨科门诊。最初的X线片未发现齿状突骨折。一个月后，她因颈部持续疼痛来到我院。X线和计算机断层扫描显示骨折继发C1-2半脱位。进行了枕后C1-C2-C3固定，患者术后佩戴头环背心两个月。两个月后，拆除头环背心，患者无任何疼痛或神经功能缺损。在老年患者中，即使是轻微的头部外伤也可能导致颈椎骨折。因此，在初始评估时应考虑潜在骨折，以避免初始诊断错误的严重后果。在选择保守或手术治疗时应谨慎，考虑所有潜在风险和并发症。
