Case Report

Thoracolumbar Fracture-Dislocation in Child Abuse: Case Report, Closed Reduction Technique and Review of the Literature
James P. Sieradzki, John F. Sarwark

Orthopaedic Surgery, Children's Memorial Hospital, Northwestern University's Feinberg School of Medicine, Chicago, Ill., USA

Address of Corresponding Author

Pediatr Neurosurg 2008;44:253-257 (DOI: 10.1159/000121475)

  Key Words

• Child abuse
• Thoracolumbar fracture dislocation
• Closed reduction technique

  Abstract

There have been very few reports in the literature of management of thoracolumbar fracture dislocations in very young children. The following is a presentation of one of these rare cases that was treated using a closed reduction method that has been little described in the medical literature. A 14-month-old child suffered a fracture dislocation at T₁₂-L₁ from nonaccidental trauma. The patient was neurologically intact upon admission. Treatment consisted of closed manual reduction and hyperextension casting under sedation. At 22-month follow-up, the patient displayed excellent clinical and radiographic results and remained neurologically intact. The operative technique is presented in detail and relevant literature reviewed. We propose that closed reduction and extension casting may be an acceptable treatment for infantile thoracolumbar fracture dislocations in neurologically intact patients.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

John F. Sarwark, MD
Children's Memorial Hospital
2300 Children's Plaza
Chicago, IL 60614 (USA)
Tel. +1 773 327 1232 , Fax +1 773 327 1166, E-Mail j-sarwark@northwestern.edu

  Article Information

Received: January 15, 2007
Accepted after revision: September 18, 2007
Published online: March 27, 2008
Number of Print Pages : 5
Number of Figures : 4, Number of Tables : 1, Number of References : 20