Atlantoaxial instability in a 7-year-old boy associated with traumatic disrupture of the ossiculum terminale (apical odontoid epiphysis).
A case of atlantoaxial instability with a rare etiology in a boy of 7 years and 3 months is presented. Computerized tomography with three-dimensional reconstruction revealed avulsion of the ossiculum terminale (apical odontoid epiphysis). Developmental peculiarities and relevant disorders of the infantile upper cervical spine are discussed. Temporary posterior C1/C2 fusion and transdental screw fixation of the ossiculum terminale were attempted in order to stabilize C1/C2 and avoid permanent fusion. After removal of the dorsal implants, the transdental screw broke, the instability recurred and a permanent atlantoaxial fusion had to be performed.
Department of Orthopedic Surgery, University of Erlangen-Nuremberg, Germany.
B
B
Swoboda
H
H
Hirschfelder
D
D
Hohmann
D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D002648:Child; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D012421:Rupture; D014057:Tomography, X-Ray Computed