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Case Reports
. 2021 Feb 20:32:100444.
doi: 10.1016/j.tcr.2021.100444. eCollection 2021 Apr.

Suicidal jumper's fracture reduced with hyperextension and the joystick method: A case report

Toru Matsugaki  1 , Hideaki Shibata  1 , Yuhei Esaki  1 , Tsunemasa Matsubara  1 , Ryota Takami  1
Affiliations
Case Reports

Suicidal jumper's fracture reduced with hyperextension and the joystick method: A case report

Toru Matsugaki et al. Trauma Case Rep. .

Erratum in

Abstract

Suicidal jumper's fractures are transversal fractures of the upper sacrum. The treatment for this type of fracture remains controversial. We present a case of a Roy-Camille type 2 suicidal jumper's fracture treated with reduction by hyperextension of the lumbosacral junction, the joystick method, and percutaneous fixation on the day of injury. After the operation, the sacral canal at the S2 level was enlarged and both lower extremities began to move gradually. At 19 days after the injury, direct decompression via sacral laminectomy was performed to promote further neurological improvement. At 10 months after the injury, cauda equina syndrome and radicular symptoms were completely resolved. Considering its minimal invasiveness, we recommend trying hyperextension and the joystick method to treat Roy-Camille type 2 suicidal jumper's fractures on the day of injury.

Keywords: Hyperextension; Joystick method; Suicidal jumper's fracture; Transverse sacral fracture.

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Conflict of interest statement

The authors declare that they have no conflicts of interest in connection with this paper. All authors confirm that they have no financial or personal relationships with other people or organizations that could inappropriately influence this work.

Figures

Fig. 1
Fig. 1
(a) Three-dimensional computed tomography (CT) showed an H-shaped Roy-Camille type II sacral fracture and a L1 burst fracture on admission. (b) Sagittal CT demonstrated the displaced fragment obstructing the sacral canal at the S2 level. (c) Axial CT showed 30% spinal canal compromise at the L1 level.
Fig. 2
Fig. 2
(a) Patient position during reduction of the pelvis. Hyperlordosis was induced by placing a triangular pillow under the lumbosacral junction. (b) The reduction force was applied in the direction of the arrow to hyperextend the lumbosacral junction.
Fig. 3
Fig. 3
Intraoperative lateral fluoroscopic view (a) before and (b) after reduction. Schematic diagram (c) before and (d) after reduction. The angle of lordosis at the L5/S1 disc space after reduction was greater than the angle before reduction. The lower fragment moved dorsally and caudally with the half pins. The fracture was reduced with ligamentotaxis.
Fig. 4
Fig. 4
(a) Radiograph of the pelvis and (b) Sagittal computed tomography (CT) image after emergent surgery. The sacral canal at the S2 level was enlarged. (c) Radiograph of the lumbar spine after percutaneous fixation for the L1 burst fracture. (d) Radiograph and (e) CT image of the pelvis at 10 months after the injury.
See this image and copyright information in PMC

References

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