Tags

Type your tag names separated by a space and hit enter

Complete Atlantoaxial Dislocation After Odontoid Synchondrosis Fracture: A 2-Year Follow-up Study: A Case Report.
JBJS Case Connect 2019 Apr-Jun; 9(2):e0327JC

Abstract

CASE

Spine injuries are rare in children, but when they do occur, the synchondrosis of C2 may be involved. A 5-year-old boy presented to our clinic complaining of neck pain for 6 weeks, which started after wrestling with peers. He had slight upper extremity weakness, clonus, and diminished reflexes. Imaging, including computed tomography and magnetic resonance imaging scans, showed a fracture dislocation through the synchondrosis of the odontoid. The patient was initially treated with admission to the hospital, awake halo placement, and gradual traction over a few days. Subsequently, he was taken for transoral reduction and posterior instrumented fusion of C1-C3 using a combination of sublaminar suture, screws, and rods. Most recently, he was doing well over 2 years later, with no residual neurologic symptoms.

CONCLUSIONS

The case presented demonstrates one option for an otherwise nonreducible odontoid synchondrosis fracture with complete atlantoaxial dislocation: transoral reduction and open posterior instrumentation. This proved to be a practical technique and provided a good clinical result in this case. These injuries are rare, but when they do occur, the examination can be surprisingly subtle given the severity of the injury. Plain films should be scrutinized carefully and advanced imaging obtained when necessary to confirm the diagnosis.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Stanford University, Stanford, California.Department of Orthopaedic Surgery, Stanford University, Stanford, California.Department of Orthopaedic Surgery, Stanford University, Stanford, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31188795

Citation

Karamian, Brian A., et al. "Complete Atlantoaxial Dislocation After Odontoid Synchondrosis Fracture: a 2-Year Follow-up Study: a Case Report." JBJS Case Connector, vol. 9, no. 2, 2019, pp. e0327.
Karamian BA, Campbell ST, Rinsky LA. Complete Atlantoaxial Dislocation After Odontoid Synchondrosis Fracture: A 2-Year Follow-up Study: A Case Report. JBJS Case Connect. 2019;9(2):e0327.
Karamian, B. A., Campbell, S. T., & Rinsky, L. A. (2019). Complete Atlantoaxial Dislocation After Odontoid Synchondrosis Fracture: A 2-Year Follow-up Study: A Case Report. JBJS Case Connector, 9(2), pp. e0327. doi:10.2106/JBJS.CC.18.00327.
Karamian BA, Campbell ST, Rinsky LA. Complete Atlantoaxial Dislocation After Odontoid Synchondrosis Fracture: a 2-Year Follow-up Study: a Case Report. JBJS Case Connect. 2019;9(2):e0327. PubMed PMID: 31188795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complete Atlantoaxial Dislocation After Odontoid Synchondrosis Fracture: A 2-Year Follow-up Study: A Case Report. AU - Karamian,Brian A, AU - Campbell,Sean T, AU - Rinsky,Lawrence A, PY - 2019/6/13/pubmed PY - 2019/6/13/medline PY - 2019/6/13/entrez SP - e0327 EP - e0327 JF - JBJS case connector JO - JBJS Case Connect VL - 9 IS - 2 N2 - CASE: Spine injuries are rare in children, but when they do occur, the synchondrosis of C2 may be involved. A 5-year-old boy presented to our clinic complaining of neck pain for 6 weeks, which started after wrestling with peers. He had slight upper extremity weakness, clonus, and diminished reflexes. Imaging, including computed tomography and magnetic resonance imaging scans, showed a fracture dislocation through the synchondrosis of the odontoid. The patient was initially treated with admission to the hospital, awake halo placement, and gradual traction over a few days. Subsequently, he was taken for transoral reduction and posterior instrumented fusion of C1-C3 using a combination of sublaminar suture, screws, and rods. Most recently, he was doing well over 2 years later, with no residual neurologic symptoms. CONCLUSIONS: The case presented demonstrates one option for an otherwise nonreducible odontoid synchondrosis fracture with complete atlantoaxial dislocation: transoral reduction and open posterior instrumentation. This proved to be a practical technique and provided a good clinical result in this case. These injuries are rare, but when they do occur, the examination can be surprisingly subtle given the severity of the injury. Plain films should be scrutinized carefully and advanced imaging obtained when necessary to confirm the diagnosis. SN - 2160-3251 UR - https://www.unboundmedicine.com/medline/citation/31188795/Complete_Atlantoaxial_Dislocation_After_Odontoid_Synchondrosis_Fracture:_A_2-Year_Follow-up_Study:_A_Case_Report L2 - http://Insights.ovid.com/pubmed?pmid=31188795 DB - PRIME DP - Unbound Medicine ER -