Musculoskeletal case studies for medical students

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A 26 year old male involved in a motor vehicle accident.

The patient had a head injury. No other long bone fractures were present. Anal tone was normal.

Initial X ray
Description Lateral X ray
X ray
Problem The 26 yr. old male with a head and a cervical injury.
X ray after treatment
Description CT Scan
Post management further view
Classification The lateral X-ray shows anterior translation of C2 on C3. The anterior cervical line as well as the posterior cervical body line are translated anteriorly. The fracture lines are obscured by an ecg probe. A CT scan was indicated to show detail of the fracture. The CT above confirms a pedicle region fracture. This is a hangman's fracture.
Discussion of management

Orthopaedic Management:

Cone's calipers were inserted and the patient placed on a double mattress, ending at he shoulders (for extension). 3.5 kg traction surfficed to give a good reduction of the fracture. A check (lateral) x ray taken in the ward confirmed a good reduction. The fracture united with 6 weeks traction and a further 6 weeks immobilization at home in a SOMI brace.


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