Emergency Closed Reduction of a C4/5 Fracture Dislocation with Complete Paraplegia Resulting in Profound Neurologic Recovery

Case Reports in Orthopedics, 2013 · DOI: 10.1155/2013/272865 · Published: August 13, 2013

Simple Explanation

A 37-year-old patient with complete paraplegia due to a C4/5 fracture dislocation experienced significant neurological recovery after emergency closed reduction performed approximately 120 minutes post-trauma. The patient's condition improved from AIS grade A (complete loss of motor and sensory function) to grade D (ambulatory without walking aids) after treatment and rehabilitation. This case suggests that very early reduction of the dislocated cervical spine, followed by stabilization and rehabilitation, may improve outcomes in patients with spinal cord compression.

Study Duration

One year

Participants

One 37-year-old female patient

Evidence Level

Level 4: Case Report

Key Findings

1
Emergency closed reduction within 120 minutes of a C4/5 fracture dislocation with complete paraplegia resulted in significant neurological recovery.
2
The patient progressed from AIS grade A to AIS grade D within one year, regaining the ability to walk without assistance and resume horse riding.
3
Early decompression of the spinal canal, when feasible, may lead to surprisingly good clinical outcomes in similar cases.

Research Summary

This case report describes a 37-year-old patient who experienced a C4/5 fracture dislocation with complete paraplegia after being hit by a horse. Emergency closed reduction was performed approximately 120 minutes after the trauma, followed by anterior decompression, discectomy, and fusion. The patient's neurological function improved significantly, ultimately regaining the ability to walk and resume her previous activities, highlighting the potential benefits of early intervention.

Practical Implications

Early Intervention

Prompt closed reduction in cervical fracture dislocations may improve neurological outcomes.

Rehabilitation Importance

Intensive neurological rehabilitation is crucial for maximizing functional recovery.

Individualized Treatment

Careful consideration of risks and benefits is necessary when attempting closed reduction due to potential complications.

Study Limitations

1
Single case report limits generalizability
2
Potential for publication bias
3
Difficult to determine causality between early reduction and neurological recovery

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