Application of the Canadian C-Spine Rule during early clinical evaluation of a patient presenting in primary care with a C2 fracture following a motor vehicle collision: A case report

作者：Rossettini Giacomo; Rondoni Angie; Testa Marco^*

来源：International Journal of Osteopathic Medicine, 2015, 18(3): 230-236.

DOI：10.1016/j.ijosm.2015.02.008

• Cervical vertebrae
• Bone fractures
• Primary health care
• Differential diagnosis
• Clinical decision-making

Background: Neck pain related to a recent minor trauma could mask a cervical spine fracture, even in the absence of neurological signs and symptoms.
Objective: The purpose of this article is to report a case of safe management of a patient involved in a minor importance motor vehicle collision, concealing an odontoid fracture.
Clinical features: A patient involved in a minor blunt trauma self-referred to a physical therapist's outpatient clinic the day after, complaining of pain of medium severe intensity, slight nausea, headache and cervical mobility restriction raised during the night, many hours after the collision. No neurological signs were present.
Intervention and outcome: A detailed case history which aimed to screen for red flags and the Canadian C-Spine Rule application combined with clinical examination, facilitated the diagnosis of an odontoid fracture of the C2 vertebra. This led to a safe and effective management procedure of the patient and an adequate therapy with a rigid Philadelphia neck brace for 60 days.
Conclusion: Implementation of the Canadian C-Spine Rule in outpatient clinics can be very helpful to avoid unnecessary imaging and, in the meanwhile, to guarantee safe practice.

• 出版日期2015-9