JBJS | Flexion-Distraction Injury of the Upper Thoracic Spine Associated with Tracheoesophageal Perforation : A Case Report

The Journal of Bone & Joint Surgery, Volume 84, Issue 6

Case Reports | June 01, 2002

Flexion-Distraction Injury of the Upper Thoracic Spine Associated with Tracheoesophageal Perforation : A Case Report

Shih-Hao Chen, MD; Tsung-Jen Huang, MD; Yeung-Jen Chen, MD; Hui-Ping Liu, MD; Robert Wen-Wei Hsu, MD

The Journal of Bone & Joint Surgery. 2002; 84:1028-1031

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Blunt chest trauma with tracheoesophageal perforation is an unusual and potentially catastrophic event. More than 60% of patients with these injuries-which are often associated with multiple major vessel tears, cardiopulmonary tamponade, or tension pneumothorax-die before reaching a hospital or during resuscitation ¹ . Tracheoesophageal perforations in the cervical region are most often caused by penetrating injuries or by blunt trauma causing cervical hyperextension. Such injuries are less frequently recognized in the thoracic area ^2,3 . Combined perforations of the "common weak wall" of the trachea and esophagus in the upper thoracic region can present challenges such as airway obstruction, septic pleuromediastinitis, and unstable hemodynamics. Furthermore, concurrent vertebral fracture with spinal cord damage can confound the course of management. We report a case of a motorcyclist with an upper thoracic spine fracture associated with incomplete spinal cord damage and a tracheoesophageal perforation.

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upper thoracic spine ; tracheoesophageal perforation ; fracture

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