title: Traumatic facet joint dislocation in Western Australia.
abstract: BACKGROUND
  Facet joint dislocation is a traumatic injury, which frequently results in devastating clinical outcomes. In Western Australia (WA), Royal Perth Hospital (RPH) provides a statewide Spinal Trauma Service and accepts all referrals from the entirety of the state. The economies of distance in WA mean that there is often a considerable delay between initial presentation at the peripheral hospital and enlocation of the dislocation in Perth. This study aims to identify any prejudicial clinical outcomes as a consequence of this delay.
  
  
  METHODS
  This study retrospectively examines all facet joint dislocations that presented to RPH between in a 46-month period. Data were collected on the demographics of patients, mechanism of injury, neurological assessment at presentation of injury based on the American spinal injury association (ASIA), initial presentation to RPH, post-surgical reduction and post rehabilitation.
  
  
  RESULTS
  Over this time there were 23 urban patients and 28 rural patients. In the urban group, 18 patients had a final ASIA score of D or E while 5 patients had a final ASIA score of A, B or C. In the rural group, 17 patients had a final ASIA score of A, B or C while 11 patients had a final ASIA score of D or E.
  
  
  CONCLUSIONS
  This study confirms the challenges of management of these injuries in a large geographical area, with a centralised spinal trauma service. Generally, facet joint dislocations that had delayed reductions had a poorer outcome. We hope that the proposed protocol would deliver better management of these injuries.
authors.affiliation: Royal Perth Hospital, PO BOX 218, Nedlands, WA, 6009, Australia. vivek@eranki.com.au.
authors.forename: Vivek
authors.initials: V
authors.lastname: Eranki
authors.affiliation: Clinical services, Royal Perth Hospital, 197 Wellington street, Perth, WA, 6000, Australia.
authors.forename: Kongposh
authors.initials: K
authors.lastname: Koul
authors.affiliation: Faculty of Medicine and Health Sciences, University of Notre Dame, 160 Oxford St, Darlinghurst, NSW, 2010, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Mendz
authors.affiliation: Department of Orthopaedics and Trauma, Royal Perth Hospital, 197 Wellington street, Perth, WA, 6000, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Dillon
mesh_terms: D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery; D002985:Clinical Protocols; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019637:Orthopedic Procedures / Q000379:methods; D012189:Retrospective Studies; D012423:Rural Health; D013124:Spinal Injuries / Q000601:surgery*; D013997:Time Factors; D014504:Urban Health; D014904:Western Australia; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000293:injuries* / Q000601:surgery
keywords: Cervical spine dislocation; Motor vehicle accident; Spinal dislocation; Spinal trauma