当锄头骨折不再是锄头骨折时：一例报告。
When Is a Clay-Shoveler's Fracture, Not a Clay-Shoveler's Fracture?: A Case Report.
作者信息
Schultz Matthew J, Wheeler Michael R, Black Loren O, Morrell Aidan T, Philipp Travis C
机构信息
Jefferson Health New Jersey, Stratford, New Jersey.
Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, Oregon.
出版信息
JBJS Case Connect. 2024 Oct 3;14(4). doi: 10.2106/JBJS.CC.24.00149. eCollection 2024 Oct 1.
CASE
A 71-year-old man with a history of C5-7 anterior cervical discectomy and fusion (ACDF) sustained a C7 spinous process fracture after falling from a ladder. He was initially managed nonoperatively but developed anterolisthesis and kyphosis at C7-T1 with left hand weakness over the course of 11 days. Surgical treatment included spinous process wiring and C5-T3 posterior fusion. At 14-month follow-up, he demonstrated resolution of pain and returned motor function.
CONCLUSION
The patient's ACDF likely created a longer lever arm, allowing the force of his fall to be concentrated at C7-T1. Patients with a suspected Clay-Shoveler's fracture require close follow-up.
病例
一名 71 岁男性，曾行 C5-7 颈椎前路椎间盘切除融合术（ACDF），因从梯子上坠落而导致 C7 棘突骨折。最初采用非手术治疗，但在 11 天内出现 C7-T1 椎体前滑移和后凸畸形，并伴有左手无力。手术治疗包括棘突钢丝固定和 C5-T3 后路融合。在 14 个月的随访中，患者疼痛缓解，运动功能恢复。
结论
患者的 ACDF 可能形成了更长的力臂，导致其坠落的力量集中在 C7-T1 。怀疑有 Clay-Shoveler 骨折的患者需要密切随访。
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