Fracture dislocation of

the V th XI – XII Frankel

A
2nd patient
IDENTITY
• Name : Sogini
• Sex : Male
• Age : 55 y.o
• Medical Record : 281559
• Ward : PS
 Primary Survey

Male 55 yo, came to emergency room with chief complain

unable move both of his leg after falling
A: Clear
B: Spontaneous,ThoracoAbdominal, RR: 20 x/m
C: HR: 80 x/m, BP : 131/87 mmHg
D: GCS E4V5M6, isochoric pupil (3 mm/3 mm)
E: T : 36,5 C, lesion (+) look at physical examination
 Secondary Survey
• Chief Complaint : unable to move both of his leg

• History of illness :
12 hours prior to admission, patient fell down from the tree 6
meters height in sitting position. After the injury, patient felt
sharp pain on his back that aggravated by trunk movement. He
was unable to move both of his leg. He felt numbness over both
leg. He was unable to urinate after the injury.
History of Past illness :
There was no pain, deformity or trauma before accident.
 Secondary Survey

Head : no abnormality
Neck : no abnormality
Eyes : no abnormality
Nose : no abnormality
Ears : no abnormality
Mouth : no abnormality
Chest : no abnormality
Back : look at neurological examination
Abdominal : no abnormality
Extremities : no abnormality
 Physical Examination
Thoracolumbar Region
L : skin intact, bruising (-), swelling(+), kyphotic deformity (+)
F : Tenderness (+) at thoracolumbar junction, step off (+)
M : ROM lumbar spine not evaluated
Neurological Examination
Sensoric : anesthesia Th XI
Motoric :

Reflex Physiologic: patella (-) /

D S Achilles (-)
C5 5 5 Reflex Patologic : (-)
C6 5 5 Clonus (-)
C7 5 5
C8 5 5 Reflex :
T1 5 5 Bulbocavernous reflex (+)
L2 0 0
L3 0 0
L4 0 0
L5 0 0
S1 0 0
 1st assesment
Susp Fracture Dislocation thoracolumbar junction
Frankel A
DD : Burst Fracture thoracolumbar junction
Frankel A
Compresion Fracture thoracolumbar
junction Frankel A
Plan:
• In line Immobilization
• Analgesic
• X ray
• Laboratory
 Cobb angle : 13o
LOABH : 50 %
LOPBH :0%
Translation : 45%

TLICS
Morphology : 3
Neurologic : 2
PLC : 3
Total 8
2nd Assesment

Fracture dislocation of the V th XI – XII Frankel A

AO : 52-C3
VAS : 4-5
ISS : 9
Plan II
MRI

Definitive treatment
Open Reduction, Decompression and stabilization