Itoi Akira, Nojiri Hidetoshi, Takahashi Ryosuke, Shimura Arihisa, Kojou Tomoya, Higashiura Yuya, Ushimaki Takahiro, Mogami Atsuhiko
Department of Orthopaedic Surgery, Juntendo University Shizuoka Hospital, Izunokuni, JPN.
Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Bunkyo, JPN.
Cureus. 2025 Aug 27;17(8):e91144. doi: 10.7759/cureus.91144. eCollection 2025 Aug.
Cervical distractive-flexion (DF) injuries are occasionally overlooked on initial evaluation, leading to delayed diagnosis at the stage of dislocation or late-onset neurological symptoms. Although detailed evaluation of osseous injury has become possible with the widespread use of CT, diagnosis remains challenging when DF injuries are spontaneously reduced in the supine position during imaging. According to the Allen-Ferguson classification, minor fractures of the superior articular process are indicative of DF injuries; however, few reports mention the evaluation of such findings in cases of delayed dislocation. This report presents a case of DF injury (Stage 1) diagnosed by recognizing a minor fracture of the articular process and subtle widening of the contralateral facet joint, leading to appropriate imaging evaluation and timely diagnosis.
颈椎牵张屈曲（DF）损伤在初次评估时偶尔会被忽视，导致在脱位阶段延迟诊断或出现迟发性神经症状。尽管随着CT的广泛应用，对骨损伤进行详细评估已成为可能，但当DF损伤在成像过程中于仰卧位时自发复位，诊断仍具有挑战性。根据艾伦 - 弗格森分类，上关节突的轻微骨折提示DF损伤；然而，很少有报告提及在延迟脱位病例中对这些发现的评估。本报告介绍了一例通过识别关节突轻微骨折和对侧小关节面轻微增宽而诊断出的DF损伤（1期）病例，从而得以进行适当的影像学评估并及时诊断。
