title: Internal fixation without fusion of a flexion-distraction injury in the lower cervical spine of a three-year-old.
abstract: BACKGROUND
  Reported surgical treatment of unstable pediatric cervical spine injuries typically involves posterior fusion with internal fixation, usually with posterior wiring.
  
  
  OBJECTIVE
  To discuss management issues in the treatment of an unstable Salter-Harris type I pediatric cervical spine injury and surgical intervention without fusion.
  
  
  METHODS
  A case report.
  
  
  METHODS
  Summary of the management of an unstable flexion-distraction injury in a 3-year-old child is presented with literature review.
  
  
  RESULTS
  A rare unstable flexion distraction injury of the pediatric cervical spine was successfully treated with posterior wiring without fusion. The wires underwent fatigue failure and maintenance of motion achieved without instability at 2-year follow-up.
  
  
  CONCLUSIONS
  In select physeal injuries of the pediatric cervical spine, internal fixation can provide stability while healing occurs, with avoidance of fusion and maintenance of motion.
authors.affiliation: Department of Orthopedic Surgery, Scott and White Memorial Hospital and Clinic, 2401 South 31st Street, Temple, TX 76508, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Hooley
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Chaput
authors.forename: Mark
authors.initials: M
authors.lastname: Rahm
mesh_terms: D000063:Accidents, Traffic; D002574:Cervical Vertebrae; D002675:Child, Preschool; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome