Thoracolumbar fracture-dislocation in child abuse: case report, closed reduction technique and review of the literature.

There have been very few reports in the literature of management of thoracolumbar fracture dislocations in very young children. The following is a presentation of one of these rare cases that was treated using a closed reduction method that has been little described in the medical literature. A 14-month-old child suffered a fracture dislocation at T(12)-L(1) from nonaccidental trauma. The patient was neurologically intact upon admission. Treatment consisted of closed manual reduction and hyperextension casting under sedation. At 22-month follow-up, the patient displayed excellent clinical and radiographic results and remained neurologically intact. The operative technique is presented in detail and relevant literature reviewed. We propose that closed reduction and extension casting may be an acceptable treatment for infantile thoracolumbar fracture dislocations in neurologically intact patients.