Maintenance notice: Some features that submit or update information are temporarily disabled while we migrate the website. You can continue browsing normally. Thank you for your understanding.
Click on images to view larger radiographs and clinical pictures.
Introduction
This 29 year old man was the driver of a pickup truck which collided head-on with another car and rolled onto the passenger's side. The passenger was dead at the scene. The driver was found with his body outside the driver's side window and head inside the truck, caught around the seatbelt. Paramedics applied a KED and semirigid C-spine collar at the scene and he was brought to the closest hospital. IV Steroids were instituted for a suspected C-spine injury and he was transfered to a tertiary care centre. On arrival, his airway is patent, the C-spine is in a semirigid collar, and he his hemodynamically stable on 100% Oxygen. Physical examination reveals tenderness in the mid-to-lower C-spine. Neurological examination shows that this man has a C6 sensory and motor level. There is no rectal tone and a negative bulbocavernosus reflex is noted. There are no other injuries.
Radiographs of the C-spine
A Halo is applied on admission, and sequential weights are used to attempt a closed reduction of the C-spine:
(After 20 Lbs)
(After 30 Lbs)
The C-spine reduces with 40 lbs weight but the neurological deficit persists.
The patient was taken to the operating room the following day for instrumentation.
If you have orthopedic information that you would like to share with the Orthogate Community, please register/login and submit your news, event, job, article, case or workshop from the Submit Content menu under the My Account area. Learn more!
Improving orthopaedic care, education and research using Internet technologies