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Traumatic lumbosacral dislocation in a 5-year-old boy with eight years follow-up
J Beguiristain1, D Schweitzer, G Mora
1Department of Orthopaedic Surgery, School of Medicine, University of Navarra, Pamplona, Spain.
Study Design:
The authors present an unusual case of pure traumatic bilateral lumbosacral dislocation in a 5-year-old boy, the conservative treatment carried out, and the long-term result.
Objectives:
To describe a rare traumatic lesion in children and evaluate the result obtained with conservative treatment.
Summary Of Background Data:
Watson-Jones was the first to describe this type of lesion. Since then, only a few cases have been added. Most authors suggest that open reduction should be carried out. No cases of this type of injury in children have been reported.
Methods:
A 5-year-old boy was hit in the lumbosacral region with a rocking chair. Examination showed neurologic deficit of left L5 and S1 nerve roots. Roentgenographic examination and computed tomography scan confirmed the anterior dislocation of the fifth lumbar vertebra on the sacrum without any fracture. He was treated with traction, followed by hyperextension in a Cotrel traction table and further immobilization with a lumbar plaster jacket.
Results:
Eight years after the injury, the patient had no neurologic deficit and lumbar radiographs showed a good alignment of the lumbosacral spine.
Conclusion:
In children with traumatic lumbosacral dislocation, closed reduction should be attempted even if neurologic deficit is present.