[Treatment of traumatic rotatory atlanto-axial subluxation in childhood. Case report and literature review].
Cervical spine injuries are rare in children. They tend to occur predominantly in the region of atlanto-axial articulation. Even traumatic rotatory atlanto-axial subluxation (AAD) has been described in the literature, however, there is no consistent therapeutic protocol. We report on a 4 year old girl with an acute traumatic rotatory atlanto-axial subluxation treated with closed reduction and retention in a hard-collar. Control CT scans and physical examination after 6 weeks revealed an excellent outcome without any signs of recurrence. As there is a correlation between outcome and increasing length of the dislocation-therapy interval, optimal management of acute rotatory atlanto-axial subluxation depends on early diagnosis with plain radiography and CT scans. Timely diagnosed cases may be treated successfully with closed reduction and cervical immobilisation in a hard-collar. Failure to obtain reduction and recurrence are an appropriate indication for surgical intervention.
Münch
C
C
Zentrum für Operative Medizin, Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitäts-Klinikum Hamburg-Eppendorf. cmuench@uke.uni-hamburg.de
Linhart
W
W
Storck
A
A
Papavero
L
L
Windolf
J
J
Rueger
J M
JM
Briem
D
D
D000208:Acute Disease; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D001915:Braces; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007103:Immobilization; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D011859:Radiography; D013123:Spinal Fusion; D016896:Treatment Outcome