Lumbar fracture-dislocation related to range-of-motion exercises

Range-of-motion exercises are an established and widely accepted therapeutic modality in the treatment of the person with spinal cord injury and are usually uneventful. Occasionally, however, accidents do occur; among them are fractures and dislocations of limbs. An unusual "slice" fracture of L4, related to range of motion exercises, occurred in a young man who was a quadriplegic and converted him from upper to lower motor neuron bowel, bladder and sexual function. This iatrogenic fracture, although extremely rare, can be prevented if symptoms are properly interpreted.