Late Presentation of Mismanaged Isolated Thoraco Lumbar Fracture Dislocation by Puttur Kettu: A Case Report
Thoracolumbar fracture dislocation is seen more commonly in young individuals and is often associated with significant neurological deficits. Timely management of these spine injuries is important to prevent progressive neurological deficits and other complications like persistent back pain and spinal deformities. Cases of missed injuries in the cervical spine are more frequently reported than neglected thoracolumbar trauma. The treatment of neglected cases is more challenging and complicated when compared to those that present early. We report a case of a 36 year old male who presented to us 6 months after trauma, initially treated by a traditional bone setter. Earlier, he was diagnosed to have T12-L1 fracture dislocation with “trivial” lower limb weakness and now he presented with spinal deformity, back pain and persistent lower limb weakness. He was successfully managed with a high risk surgical intervention and his Spinal Cord Independence Measure (SCIM) score improved from 60 (preoperative) to 94 (at the latest follow up). The purpose of this case report is to highlight the negligence of the traditional bone setters in treating spinal injuries, challenges in the management during the late stages and the need for educating the general public and bone setters.