Six-year follow-up of a survivor of cervical spine fracture and dislocation with oesophageal perforation following long
- PDF / 1,249,311 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 105 Downloads / 152 Views
CASE REPORT
Open Access
Six-year follow-up of a survivor of cervical spine fracture and dislocation with oesophageal perforation following long scarf syndrome - a case report and literature review Xiang Li1, Fangyong Wang2,3, Junwei Zhang2,3, Yi Hong2,3*† and Yong Yang1*†
Abstract Background: Accidental strangulation due to scarf getting caught in the wheels of a vehicle or machine was called “Isadora Duncan Syndrome” or “Long Scarf Syndrome”. Survival of concomitant fracture dislocation of cervical spine and oesophageal perforation following Long Scarf Syndrome was rarely described and medium-term follow-up for this lesion has not been reported. Case presentation: We present a 39-year-old female who suffered accidental strangulation caused by the scarf around her neck getting trapped in the wheels of the a vehicle and was referred to our hospital forty days post injury. The CT examination showed a fracture dislocation at C5/6 levels with complete dissociation of the supporting structures. She developed paravertebral abscesses, cutaneous fistulas and oesophageal perforation confirmed by oesophagoscope. The patient was treated conservatively because of poor general condition and inappropriate initial treatment. Halo-vest was used to immobilize the cervical spine. The oesophagus-cutaneous fistula was managed with enteral tube feeding and repeated local care. The patient survived despite such severe injury. Nine months after the injury, the oesophageal perforation closed spontaneously and fixed malunion of the cervical spine was achieved. Sixyear follow-up demonstrated that the patient survived with complete C5 tetraplegia. Literature associated with this lesion was reviewed and factors contributing to the survival were discussed. Conclusions: Concomitant fracture dislocation of cervical spine and oesophageal perforation following Long Scarf Syndrome is extremely rare with high risk of mortality. Though surgical intervention is always necessary, the optimal management for this kind of lesion should be made on an individual basis through a multidisciplinary approach. Keywords: Isadora duncan syndromeLong scarf syndromeCervical spine traumaOesophageal perforationConservative treatmentCase report
* Correspondence: [email protected]; [email protected] † Yi Hong and Yong Yang contributed equally to this work. 2 School of Rehabilitation Medicine, China Capital Medical University, Beijing 100068, China 1 Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, No 95 Yongan Road Xicheng District, Beijing 100050, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party
Data Loading...
