title: Misdiagnosed bilateral C5-C6 dislocation causing cervical spine instability: a case report.
abstract: BACKGROUND
  The diagnosis of cervical spine injuries remains a significant problem in many blunt trauma patients. Correct and early diagnosis of these injuries is imperative as delayed or missed diagnoses result in increased morbidity and mortality.
  
  
  METHODS
  A 57-year-old Caucasian woman presented with a misdiagnosed bilateral C5-C6 dislocation one month after a fall and head injury, without clearance of the cervical spine in her previous visits to two physicians and having already started physiotherapy sessions, despite the presence of pain in the clinical examination. Dislocation was treated with open reduction and spinal fusion with posterior instrumentation 4 weeks post-trauma.
  
  
  CONCLUSIONS
  Every physician should be highly suspicious of cervical spine injury in blunt trauma patients with positive clinical examination and include radiologic studies in his screening modality. Physiotherapy sessions should under no circumstances be started in the presence of underlying spine injury.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Ioannina, St. Niarchos Avenue 45500, Ioannina, Greece. idgelalis@msn.com
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Gelalis
authors.forename: Georgios
authors.initials: G
authors.lastname: Christoforou
authors.forename: Christina M
authors.initials: CM
authors.lastname: Arnaoutoglou
authors.forename: Angelos N
authors.initials: AN
authors.lastname: Politis
authors.forename: Gregory
authors.initials: G
authors.lastname: Manoudis
authors.forename: Theodoros A
authors.initials: TA
authors.lastname: Xenakis