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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/ %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%