Traumatic atlantoaxial distraction injury: a case report.
METHODS
Case report.


OBJECTIVE
Description of a rarely reported variant of traumatic C1-C2 dislocation and discussion of a favorable outcome in a nonsurgical treatment approach.


BACKGROUND
Atlantoaxial dislocation most commonly involves an anterior movement of C1 in relation to C2. Often, the integrity of the transverse ligament or odontoid process is compromised, and the atlantodental interval changed. The described patient sustained a purely craniocaudal atlantoaxial distractive lesion secondary to injury sustained in a high-speed motor vehicle accident.


RESULTS
The initial treatment plan involved surgical stabilization subsequent to healing of a C1 ring fracture. After 12 weeks of external stabilization, ligamentous damage appeared well resolved. That there was no gross instability delayed using a surgical option. At periodic checkup, the patient was without symptoms.


CONCLUSIONS
In this case, conservative management of a ligamentous C1-C2 injury was effective. At 5 years after trauma the patient was without sequelae. This outcome is in contrast to previous management of injuries of this type, all of which involved surgical intervention.
Upstate Medical University, Department of Orthopedic Surgery, Syracuse, New York 13202, USA.
E A
EA
Carroll
B
B
Gordon
C A
CA
Sweeney
S
S
Joy
P J
PJ
Connolly
D000063:Accidents, Traffic; D000328:Adult; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D011859:Radiography; D020127:Recovery of Function / Q000502:physiology; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D014143:Traction; D016896:Treatment Outcome