title: Fluoroscopically guided, transoral, closed reduction, and halo vest immobilization for an atypical C-1 fracture.
abstract: Fractures through the ring of the C-1 vertebrae are very rare in the pediatric patient population. In this report, the authors describe the case of a widely displaced fracture of the C-1 anterior arch in a 6-year-old boy. The fracture was initially treated using a fluoroscopy-guided, transoral, closed reduction with subsequent halo vest immobilization. Although conservative management of C-1 fractures is generally adequate and efficacious in the pediatric population, mechanistic and anatomical considerations in this case were concerning for potential instability in extension, and prompted an unusual method of closed reduction followed by treatment in a halo vest.
authors: Division of Neurosurgery, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
authors: Matthew R
authors: MR
authors: Sanborn
authors: Michael L
authors: ML
authors: DiLuna
authors: Robert G
authors: RG
authors: Whitmore
authors: Phillip B
authors: PB
authors: Storm
mesh_terms: D000063:Accidents, Traffic; D001268:Atlanto-Axial Joint / Q000002:abnormalities; D002574:Cervical Vertebrae / Q000293:injuries* / Q000601:surgery*; D002648:Child; D057207:Child Restraint Systems; D000013:Congenital Abnormalities; D005471:Fluoroscopy; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009984:Orthopedic Fixation Devices; D019637:Orthopedic Procedures; D013123:Spinal Fusion; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed