title: Atlanto-axial dislocation complicating a type II odontoid fracture. Reduction and final fixation.
abstract: A case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture is reported. This is a rare case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture. Its management is discussed. A traumatic dislocation of atlanto-axial joint associated with an odontoid fracture remains a rare injury. No case of posterior dislocation has been reported so far in the literature with this type of management. The case is of a 25 year-old-man with a primary atlanto-axial posterolateral dislocation associated with a type II displaced odontoid fracture without any neurological complication. The patient underwent gentle traction during 24 hours with a halo frame. An incomplete reduction was achieved. Two days later, a complete reduction was obtained thanks to a preoperative manual traction maintained by a Mayfield (R) modified skull clamp. Anterior C1-C2 fixation was performed according to Vaccaro's technique. The patient wore a cervical collar and underwent physiotherapy during three months. To our best knowledge, this case represents the first traumatic atlanto-axial dislocation associated with an odontoid fracture which was treated through retropaharyngeal approach. This had been rendered possible thanks to the final reduction maneuver in extension.
authors.affiliation: Service de chirurgie orthopédique et traumatologie, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013, Paris, France; Faculté de Médecine Pierre et Marie-Curie, Site La Pitié, 91 et 105, boulevard de l'Hôpital, 75634 Paris, France. Electronic address: g.riouallon@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Riouallon
authors.affiliation: Service de chirurgie orthopédique et traumatologie, hôpital Pitié-Salpétrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013, Paris, France; Faculté de Médecine Pierre et Marie-Curie, Site La Pitié, 91 et 105, boulevard de l'Hôpital, 75634 Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Pascal-Moussellard
mesh_terms: D000328:Adult; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D001858:Bone Nails; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Atlanto-axial; C1-C2; Cervical traction; Cervical trauma; Odontoid fractures; Posterior dislocation; Vaccaro