cervical spine fracture dislocation

Introduction

Introduction to cervical fracture and dislocation The mechanism of rupture of fracture and dislocation is not fundamentally different from that of flexion cervical spine injury, but its violent effect is stronger, causing greater damage and more serious clinical symptoms. Cervical vertebral fractures, accompanied by severe dislocation of the vertebral joints, known as cervical fracture and dislocation. This is a typical complete injury, which is not uncommon in clinical practice. It is often accompanied by spinal cord injury, which occurs in the three intervertebral spaces of the neck 4-5 and the neck 6-7. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: pneumonia, bloating, hemorrhoids, urinary tract infection

Cause

Causes of cervical spine fracture and dislocation

This mechanism of rupture of fracture and dislocation is not fundamentally different from that of flexion cervical spine injury, but its violent effect is stronger, the damage caused is greater, and the clinical symptoms are more serious. It is common in flexion injury, vertebral compression fracture and facet joint. Dislocation occurs almost simultaneously, and can also be seen in vertical violence. At the same time as the rupture of the vertebral body, the facet joint appears semi-dislocation or interlocking sign. This kind of complete injury of the cervical vertebra is more serious, and most of them have Cervical spinal cord injury, except for a few "lucky injury" with a wide sagittal diameter.

Prevention

Prevention of cervical fracture and dislocation

Disease care

1. Flat-bed hard bed, soft pad or air cushion, soft pillow between the legs when lying on the side to prevent mutual squeeze, keep the bed clean, dry, buttocks to protect the skin, bone protrusion and pressure parts with ethanol massage Promote blood circulation; every 2 hours in the early stage, every 4 hours in the late stage, to prevent hemorrhoids.

2. Indwelling catheterization, early continuous opening of the catheter, 5 to 7 days after every 4 ~ 6h open, weekly replacement of the catheter should be intermittent 2 ~ 4h before inserting a new catheter, and strictly follow the aseptic operation, Flush the bladder 1~2/h through the catheter, and routinely send urine routine examination or urine culture. If there is urinary tract infection, appropriate antibiotics should be given, and patients should be encouraged to drink more water and remove the catheter as soon as possible.

3. When you have constipation, you can use Kaisailu, take laxative or enema for 1/2d, if the stool is ineffective, the device or finger will use the finger to remove the fecal mass.

4. Patients with high paraplegia should pay attention to prevent pulmonary complications. If the sputum is not coughing, the respiratory tract is not easy to maintain patency. The tracheotomy should be performed, and the patient should be treated according to the tracheotomy. Heatstroke prevention, winter should be warm.

5. Both lower extremities often perform passive exercise and muscle massage, and early exercise of upper limbs and trunk functions, prompting to sit up and get out of bed at an early date.

6. When using the bed, use a wheelchair, clip the car or practice walking under the protection of crutches and brackets.

7. After the operation of the opponent, according to the surgical method, the different parts of the corresponding treatment, the traction, according to the relevant traction routine care.

Cervical fracture and dislocation is the most serious injury in various types of injuries of the lower cervical spine. It is often accompanied by severe spinal cord injury and has a poor prognosis, except for the so-called "lucky injury" without spinal cord injury.

Complication

Complications of cervical spine fracture and dislocation Complications pneumonia bloating acne urinary tract infection

Due to serious injuries, when the plane is high, the fracture and dislocation of the neck 4 plane may cause breathing difficulties due to respiratory muscle paralysis, and secondary hypopnemic pneumonia; abdominal distension, hemorrhoids and urinary tract infections are also quite common.

Symptom

Cervical vertebrae fracture and dislocation symptoms Common symptoms neck pain thoracic vertebrae lumbar vertebrae fractures dislocation head or neck bloating and beating head and neck activity restricted neck tough

The patient has a clear history of intense trauma.

Neck pain, activity disorder, cervical tendon, extensive tenderness in the neck, severe local symptoms, spinal cord injury, except for a few lucky ones, generally have different degrees of corpus callosum, and the proportion of complete spinal cord injury is higher.

Examine

Examination of cervical spine fracture and dislocation

X-ray plain film can show fracture and dislocation, the anterior vertebral shadow is widened, CT can show the displacement of broken bone fragments, and the extent and extent of damage of spinal cord and other soft tissues need to rely on MRI images.

Imaging examination of fractures and dislocations is mainly based on X-ray plain film and CT scan; however, the determination of soft tissue injury and spinal cord state is still clear with MR images, and should be checked early.

Diagnosis

Diagnosis and diagnosis of cervical spine fracture and dislocation

The disease is usually difficult to diagnose with other diseases through typical symptoms and imaging examinations. The disease needs to be differentiated from brain injury with cervical spine injury:

1. Clinically, no spinal cord injury type fracture and dislocation is not completely asymptomatic and physical signs. Careful examination can have the following manifestations: patients with mild head injury can self-report neck occipital pain, check the curvature of the neck or present Stiffness, limited movement, and sometimes neck swelling, tenderness or nerve root irritation can be used for reference.

2. However, in patients with moderate or severe craniocerebral injury and cervical spine injury, it is difficult to distinguish between clinical and non-combined cervical spinal cord injury, especially severe craniocerebral injury and neck injury in the symptoms and signs. Therefore, it is necessary to rely on the different footprint performance of the brain and cervical spinal cord injury, MR I, autopsy and the recovery data of the patient recovery period for identification.

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