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10-SEPTEMBER-2013 ALI SALEH
MARZOOQ 52 YEARS OLD FRACTURE DISLOCATION C4-5 AFTER RTA 6 MONTHS
AGO.
Anamnesis
The patient came to the clinic 07-September-2013
complaining of neck pain and inability to move
the neck to all directions after suffering RTA
in March-2013. The patient was treated for
fracture ribs and heamothorax with UWS both
sides and fracture left forearm was plated then
after. The fracture dislocation of C4-5 was
missed at that time.
MRI of the cervical spine performed
03-September-2013 showing fracture
dislocation of C4-5.
On examination: the patient has limitation of
neck movement with pain when looking to both
sides and up and down. There is hypotrophy of
the interossii left hand with weak grip and
extension of the left hand 4/5 and triceps left
4/5.
Using C-arm, the level of
C4-5 identified. The upper edge of C5 was
dislocated posterior more from the left side.
Discectomy of C4-5 done with attempt for
reduction. Samarys cervical cage 17x13x6 mm with
bone graft was inserted to C4-5 disc space.
Trestle 16 mm length cervical plate one level
with 4 screws 14x4 mm were used to fuse C4 and
C5. All stages were done under C-arm control.
Smooth postoperative
recovery. The power of the left upper limb
became normal.
Comments
The patient still having mobile fracture
dislocation which needs surgical correction and
fixation.
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