Traumatic atlantoaxial rotatory dislocation with odontoid fracture: case report and review.
METHODS
A case of traumatic rotatory dislocation associated with odontoid fracture is reported.


OBJECTIVE
To report a rare case of traumatic rotatory dislocation associated with odontoid fracture, and to discuss the mechanism underlying spinal instability and management.


BACKGROUND
This case is a cross between traumatic rotatory fixation and atlantoaxial rotatory dislocation. Classification of rotatory subluxation change after osteosynthesis of the odontoid process was undertaken.


METHODS
A 24-year-old man sustained head and cervical injury after jumping. A Type 2 odontoid fracture without displacement was noted.


RESULTS
Without further traumatic event, 1 month after injury, computed tomography scan showed posterior displacement of the odontoid fracture and Type 4 or B atlantoaxial rotatory luxation. After surgical fixation and reduction of the odontoid fracture, the rotatory subluxation classification changed and became Type 1 or A. Posterior C1-C2 arthrodesis was performed. The patient wore a Philadelphia cervical collar for 3 months and underwent physiotherapy.


CONCLUSIONS
As the pivot of rotatory subluxation changed after odontoid process osteosynthesis, posterior C1-C2 arthrodesis was performed. The patient probably could have been treated in a single-stage procedure using posterior C1-C2 transarticular fixation with bicortical interspinous graft.
Fuentes
S
S
Department of Neurosurgery, La Timone University Hospital Center, Marseille, France. sfuentes@ap-hm.fr
Bouillot
P
P
Palombi
O
O
Ducolombier
A
A
Desgeorges
M
M
D000328:Adult; D001268:Atlanto-Axial Joint / Q000293:injuries*; D006801:Humans; D004204:Joint Dislocations / Q000150:complications*; D008297:Male; D009809:Odontoid Process / Q000293:injuries*; D016103:Spinal Fractures / Q000150:complications*