Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 1 2022 04 13 36 9 Yoosef Mehrabi Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Christophe Vidal Department of Pediatric Orthopedics, Robert Debré Hospital, Paris 7 University, AP-HP, Paris, France Saeed Reza Mehrpour Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Hossein Nabian Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2021 08 20 2022 01 06 Background: Despite improvement in technology and decision-making, misdiagnosis or delayed diagnosis of cervical spine injuries in trauma patients can cause severe irreparable neurological damage. Case Report: We present here a 56-year-old man, with a history of old bilateral C4-C5 dislocation who, contrarily to classically described unfavorable results of cranial traction in patients with older than 3 weeks cervical injury, underwent optimal reduction under cranial traction for four days and surgical intervention with an anterior surgical approach. Conclusion: Relatively high incidence of missed cervical spine injuries in polytrauma patients illustrates that proper clinical examination, use of designed protocols for clearance of cervical trauma, and accurate interpretation of radiological imaging can sometimes be neglected. https://jost.tums.ac.ir/index.php/jost/article/view/305 https://jost.tums.ac.ir/index.php/jost/article/download/305/262