Acta Orthop Belg
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Case Reports
Occult ligamentous injury of the cervical spine associated with cervical spine fracture.
We report the case of a 20-year-old patient with a C5 cervical spine fracture and an undetected ligamentous lesion between C1 and C2. Cervical spine lesion protocols and the rates of lesions that are not diagnosed with standard evaluation protocols are reviewed, with particular emphasis on comatose patients. Dynamic studies during the surgical procedure for fixation of the fracture are recommended to increase the detection of ligamentous lesions.
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Although it is widespread in orthopaedic surgery, tourniquet use is associated with appreciable morbidity and even mortality. We review the use of tourniquets, highlighting how an understanding of their design and application can reduce the complications and injuries associated with their use. We also review the attempts being made to modulate these injuries through physical and pharmacological advances, in particular looking at the phenomenon of preconditioning.