PMC7210915_01
The first image demonstrates the sagital view of both vertebral fractures (white arrow for the L2 and yellow arrow for the L5) and the second image demonstrates the lateral view of the left foot showing a comminuted intra-articular calcaneal fracture.
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F1
Radiograms and CT revealed an A3/AO type fracture of the second lumbar vertebra, a B1/AO-type fracture of the fifth lumbar vertebra, and a comminuted (sanders type 4) right calcaneal fracture (Fig. 1).
Profile view of the spinal instrumentation and profile radiogram of the right foot with the Ilizarov device application for the comminuted calcaneal fracture.
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F2
Thirty hours after the initial admission at the emergency department a posterior minimal stabilization from L1 to S2 vertebrae accompanied by L5 decompression was performed to address the spinal fractures, while an Ilizarov device was applied to reduce and temporarily stabilize the calcaneal fracture (Fig. 2).
Clinical photo on the 1st post-operative hour demonstrates the dilated left pupil.
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F3
Immediately after surgery, the left pupil was found larger than the right associated with slower and incomplete reaction to light exposition (Fig. 3).
Bedside fundus clinical image shows normal posterior vascularization, normal optic disk (blue arrow), and macula (black arrow).
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F4
Bedside fundus examination showed normal posterior vascularization and normal optic disk and macula (Fig. 4).
Clinical photo 24 h postoperatively shows equal size of both pupils and no sign of anisocoria or iris transillumination defect.
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F5
Six hours postoperatively, the anisocoria was gradually resolved and 24 h after surgery, it was completely absent (Fig. 5), while the pupillary reaction was also normal.