title: Traumatic Type III odontoid fracture and severe rotatory atlantoaxial subluxation in a 3-year-old child: case report.
abstract: In this report, the authors describe the case of a 3-year-old child with a traumatic Type III odontoid fracture. To their knowledge, this is the first reported case of a true Type III odontoid fracture with atlantoaxial rotatory subluxation in a child. The patient presented with pain and had resisted manipulation of the neck following a motor vehicle crash. Plain cervical radiographs revealed an odontoid fracture, which was confirmed by CT imaging. The left lateral mass of C-1 was rotated anterior to that of C-2 with the displaced odontoid process acting as the pivot point of rotation. The C1-2 alignment was normalized, and the C-2 fracture was reduced completely. The regional anatomy and mechanism of injury, radiographic diagnosis, and management of cervical spine injuries in children are discussed.
authors.affiliation: Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA. seldenn@ohsu.edu
authors.forename: David
authors.initials: D
authors.lastname: Panczykowski
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Nemecek
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Selden
mesh_terms: D000063:Accidents, Traffic; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007103:Immobilization; D019635:Neurosurgical Procedures; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D014057:Tomography, X-Ray Computed