HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: ptj.20070033v1 88/1/98    most recent Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ross, M. D Articles by Cheeks, J. M Search for Related Content PubMed PubMed Citation Articles by Ross, M. D Articles by Cheeks, J. M Social Bookmarking                      What's this?

Undetected Hangman's Fracture in a Patient Referred for Physical Therapy for the Treatment of Neck Pain Following Trauma

MD Ross, PT, DHS, OCS, is Chief, Department of Physical Therapy, David Grant US Air Force Medical Center, 124 Bradley Blvd, Travis AFB, CA 94535.
JM Cheeks, PT, MHS, DPT, CSST, is Physical Therapist, Deaconess Home Care, Laurel, Miss, and Doctoral Candidate, Doctor of Health Science Program, Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, Ind.

michael.ross2{at}travis.af.mil

Background and Purpose: This case report describes a patient referred for physical therapy treatment of neck pain who had an underlying hangman's fracture that precluded physical therapy intervention.

Case Description: This case involved a 61-year-old man who had a sudden onset of neck pain after a motor vehicle accident 8 weeks before his initial physical therapy visit. Conventional radiographs of his cervical spine taken on the day of the accident did not reveal any abnormalities. Based on the findings at his initial physical therapy visit, the physical therapist ordered conventional radiographs of the cervical spine to rule out the possibility of an undetected fracture.

Outcomes: The radiographs revealed bilateral C2 pars interarticularis defects consistent with a hangman's fracture. The patient was referred to a neurosurgeon for immediate review. Based on a normal neurological examination, a relatively low level of pain, and the results of radiographic flexion and extension views of the cervical spine (which revealed no evidence of instability), the neurosurgeon recommended that the patient continue with nonsurgical management.

Discussion: In patients with neck pain caused by trauma, physical therapists should be alert for the presence of cervical spine fractures. Even if the initial radiographs are negative for a fracture, additional diagnostic imaging may be necessary for a small number of patients, because they may have undetected injuries that would necessitate medical referral and preclude physical therapy intervention.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?