title: Delayed presentation of a cervical spine fracture dislocation with posterior ligamentous disruption in a gymnast.
abstract: Cervical spine injuries are uncommon but potentially devastating athletic injuries. We report a case of a girl gymnast who presented with a cervical spine fracture dislocation with posterior ligamentous disruption several days after injury. To our knowledge, this type of presentation with such severity of injury in a gymnast has not been reported in the literature. The patient was performing a double front tuck flip and sustained a hyperflexion, axial-loading injury. She experienced mild transient numbness in her bilateral upper and lower extremities lasting for about 5 minutes, after which it resolved. The patient was neurologically intact during her clinic visit, but she endorsed significant midline cervical tenderness. Plain radiographs and computed tomography imaging of the cervical spine revealed a C2-C3 fracture dislocation. She underwent posterior open reduction followed by C2-C3 facet arthrodesis and internal fixation. This case highlights the importance of very careful evaluations of neck injuries and the maintenance of high suspicion for significant underlying pathology.
authors.forename: Amit
authors.initials: A
authors.lastname: Momaya
authors.forename: Curtis
authors.initials: C
authors.lastname: Rozzelle
authors.forename: Kenny
authors.initials: K
authors.lastname: Davis
authors.affiliation: University of Alabama at Birmingham Sports Medicine, Birmingham, AL. aestes@uabmc.edu.
authors.forename: Reed
authors.initials: R
authors.lastname: Estes
mesh_terms: D001265:Athletic Injuries / Q000175:diagnosis*; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D057210:Delayed Diagnosis; D005260:Female; D006173:Gymnastics / Q000293:injuries*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000601:surgery; D017846:Longitudinal Ligaments / Q000293:injuries*; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*