Limits...
Neglected hangman fracture.

Srivastava SK, Aggarwal RA, Nemade PS, Bhoale SK - J Craniovertebr Junction Spine (2015 Oct-Dec)

Bottom Line: In Stage I, release of contracted anterior structures and C2-C3 discectomy was done in supine position followed by C2-C3 posterior fixation and fusion in Stage II.C2-C3 interbody bone grafting and anterior plating completed the third stage.The satisfactory outcome in our patient leads us to believe that anterior-posterior-anterior is the appropriate surgical approach for treatment of such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Parel, Mumbai, Maharashtra, India.

ABSTRACT
Acute management of hangman fracture is well described; however the surgical management of neglected hangman fracture has not been described in literature. We report the surgical management of an untreated hangman's fracture. A 30-year-old male had fallen from a tree 12 weeks back. Patient presented with cervical myelopathy and restricted neck movements. Radiographs and computed tomography (CT) scan revealed fracture of pars interarticularis of axis with Grade III C2-C3 spondylolisthesis with localized kyphosis of 33°. Gentle reduction under general anesthesia (GA) failed to improve the alignment. Patient was operated in three stages in a single setting. In Stage I, release of contracted anterior structures and C2-C3 discectomy was done in supine position followed by C2-C3 posterior fixation and fusion in Stage II. C2-C3 interbody bone grafting and anterior plating completed the third stage. C2-C3 interbody fusion was seen at 5 months and a CT scan at 18 months postoperative confirmed fusion and maintenance of alignment. The satisfactory outcome in our patient leads us to believe that anterior-posterior-anterior is the appropriate surgical approach for treatment of such patients.

No MeSH data available.


Related in: MedlinePlus

Computed tomography scan at 18 months showing solid C2-C3 interbody fusion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4660500&req=5

Figure 5: Computed tomography scan at 18 months showing solid C2-C3 interbody fusion

Mentions: Patient was mobilized on day 5-postoperative with SOMI brace. Anterior C2-C3 union was noted at 5 months postoperative and confirmed with X-ray [Figure 4] and CT scan [Figure 5], following which brace was discontinued. At 18 months postoperative, the patient had normal neurological examination and had resumed his pretrauma occupation.


Neglected hangman fracture.

Srivastava SK, Aggarwal RA, Nemade PS, Bhoale SK - J Craniovertebr Junction Spine (2015 Oct-Dec)

Computed tomography scan at 18 months showing solid C2-C3 interbody fusion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660500&req=5

Figure 5: Computed tomography scan at 18 months showing solid C2-C3 interbody fusion
Mentions: Patient was mobilized on day 5-postoperative with SOMI brace. Anterior C2-C3 union was noted at 5 months postoperative and confirmed with X-ray [Figure 4] and CT scan [Figure 5], following which brace was discontinued. At 18 months postoperative, the patient had normal neurological examination and had resumed his pretrauma occupation.

Bottom Line: In Stage I, release of contracted anterior structures and C2-C3 discectomy was done in supine position followed by C2-C3 posterior fixation and fusion in Stage II.C2-C3 interbody bone grafting and anterior plating completed the third stage.The satisfactory outcome in our patient leads us to believe that anterior-posterior-anterior is the appropriate surgical approach for treatment of such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Parel, Mumbai, Maharashtra, India.

ABSTRACT
Acute management of hangman fracture is well described; however the surgical management of neglected hangman fracture has not been described in literature. We report the surgical management of an untreated hangman's fracture. A 30-year-old male had fallen from a tree 12 weeks back. Patient presented with cervical myelopathy and restricted neck movements. Radiographs and computed tomography (CT) scan revealed fracture of pars interarticularis of axis with Grade III C2-C3 spondylolisthesis with localized kyphosis of 33°. Gentle reduction under general anesthesia (GA) failed to improve the alignment. Patient was operated in three stages in a single setting. In Stage I, release of contracted anterior structures and C2-C3 discectomy was done in supine position followed by C2-C3 posterior fixation and fusion in Stage II. C2-C3 interbody bone grafting and anterior plating completed the third stage. C2-C3 interbody fusion was seen at 5 months and a CT scan at 18 months postoperative confirmed fusion and maintenance of alignment. The satisfactory outcome in our patient leads us to believe that anterior-posterior-anterior is the appropriate surgical approach for treatment of such patients.

No MeSH data available.


Related in: MedlinePlus