Hiro:
Has he had any recent dx work up. x-rays, MRI etc.?
He is likely to have severe spondylosis and possibly stenosis. The C2 fracture
could have resulted in pronounced changes at C1-C2 and C2-C3 none of which can
be appreciated without imaging. Without a very good idea of what is going on at
C1-C4 I would generally stay away from these segments during treatment. You may
want to start distally with some gentle rotatory mobilizations of the upper
thoracic segments. I would have him worked up by a neurologist. It is never a
bad idea to have malpractice insurance (at least in the USA.)
> >From: "Hiro Wood" <[log in to unmask]>
> >Reply-To: [log in to unmask]
> >To: <[log in to unmask]>
> >CC: <[log in to unmask]>, <[log in to unmask]>
> >Subject: Treatment of C2 fracture
> >Date: Fri, 14 Apr 2000 23:21:39 +0900
> >
> >Hello world! from Japan
> >It's a long time since I posted last.
> >Could you teach me the treatment of C2 fracture patient?
> >1.Patient's profile
> > 76 years old retired male.He can drive a car and sometimes plow.
> >2.History
> > When he was 20 years old,he suffered from TB(tuberculosis) and had his
> >rib1
> > to rib 6 removed by operation.
> > When 30 years old,he dropped from 4 meter height head over heels and had
> >C2
> > (cervical) fractured.Mybe compression fracture I guess.No paralysis until
> >now.
> > He had been often told 'miracle',I heard.
> > When 40 years old,he suffered from vertebral compression fracture but
> >location
> > is unknown.
> >3.Other disease
> > (1)Arrhythmia (herat disease) for 20 years
> > (2)DM
> > (3)Hepatitis
> > (4)Intractable Dermatitis
> >4.Main complaint
> > (1)When he is driving a car,he cannot rotate his head in either way
> >easily
> >and
> > also has such a temporary spasm in his both thighs that he is afraid of
> >being
> > unable to put on the brake.But he has no spasm in the morning.
> > (2)Paresthesia in left 1st and 2nd finger.
> >5.Evaluation
> > (1)Structure
> > Neck is rightside bending on the trunk.
> > (2)Active movement
> > a)neck FB(forward bending)--ROM is severely limitted.5 to 10 degree.
> > b)neck SB -----Both is severly limitted and left is more limitted.
> > c)neck Rot.----same as neck SB.
> >6.Treatment
> > At first I hesitated to treat him aggresively to hear he had C2 fractured
> > before and he had many other internal diseases.
> > So I only did craniosacral therapy - inhibitive distraction for 10
> >minutes
> > in each three times.
> > He was pleased with my treatment.The result was slightly good.Recently he
> > wanted me to make him much better while he was alive.Fortunately he has
> >placed
> > his hopes on my treatment while other past patients not so much.
> > But I have only received Paris S1 course and no supervisor for my
> >treatment.
> >7.Question
> > May I advance passive motion test ie.mid cervical sidebending?Does it
> >hurt
> > fractured C2 bone?Is there any 'must not'?Had I better join medical
> >incident
> > insurance,which is recommended by Japan PT association,before going
> >ahead?
> > What influence will take place to his musculoskeletal condition when he
> >had
> > his rib1 to 6 removed?
> >
> >Thanks in advance.
> >Hiro
> >Japan
> >
> >--
*******************************************************
Douglas M. White, PT, OCS
Physical Therapist, Consultant
191 Blue Hills Parkway
Milton, MA USA 02186
P: 617.696.1974
[log in to unmask]
http://members.tripod.com/DouglasWhite/
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|