Traumatic rotary posterior dislocation of the atlas on the axis without fracture. Report of a case and review of literature.
BACKGROUND
Traumatic rotary posterior dislocation of C1 on C2 without fracture (TRPDAAWF) is a very rare complication in severe accidents, and its pathophysiology is still under debate.


METHODS
Although 6 similar cases have been reported previously, we report the lessons learned during handling of the patient. A young man who is a victim of severe car crash injury, with neglected displacement of the intact odontoid process to the front of the anterior arch of C1, is reported. Some problematic and life-threatening events in the management of the case are presented.


CONCLUSIONS
We report a new and rare case of TRPDAAWF. It is hypothesized that a similar situation could only be possible if rotary subluxation of C1 on C2 follows a severe hyperextension injury; otherwise, traumatic fracture of the odontoid process might have been inevitable.
Amirjamshidi
Abbass
A
Sina Hospital, Tehran University of Medical Sciences, Tehran 19585-678m, Iran. abamirjamshidi@yahoo.com
Abbassioun
Kazem
K
Khazenifar
Mohammed
M
Esmailijah
Akbar
A
D000063:Accidents, Traffic; D000328:Adult; D001270:Cervical Atlas / Q000293:injuries* / Q000601:surgery*; D002574:Cervical Vertebrae / Q000293:injuries; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D019547:Neck Pain / Q000209:etiology; D019635:Neurosurgical Procedures; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome