Lower limb dysesthesia--an ominous sign in lumbar fractures.
Attempts at diagnosing dural lacerations secondary to fractures of the lumbar vertebrae on plain radiographs has varied considerably. If undiagnosed these injuries can cause serious complications. We present a clinical sign not previously documented to our knowledge. Plain radiographs in this case failed to show significant canal compromise but excessive hip pain, with the limb held in a characteristic posture, heralded cauda equina injury in a burst lumbar fracture. The limb was held in hip and knee flexion, with resistance to passive extension due to lower limb dysesthesia. This sign helped in determining the investigation and treatment of our patient.
O'Connor
P A
PA
National Spinal Injuries Unit, Dept of Orthopaedic Surgery, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland. paoconn@indigo.ie
McCormack
O
O
Kennedy
J G
JG
McCormack
D
D
D000328:Adult; D006801:Humans; D007866:Leg; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D010292:Paresthesia / Q000209:etiology*; D016103:Spinal Fractures / Q000150:complications* / Q000175:diagnosis*