European Spine Journal

, Volume 18, Supplement 2, pp 168–171

Rotatory atlanto-axial dislocation in an infant with osteogenesis imperfecta

Case Report

DOI: 10.1007/s00586-008-0754-2

Cite this article as:
Humphrey, J. & Wilson-MacDonald, J. Eur Spine J (2009) 18(Suppl 2): 168. doi:10.1007/s00586-008-0754-2

Abstract

This is a case report of a 15-month-old patient with osteogenesis imperfecta (OI) who sustained atlanto-axial dislocation. Our objective is to report a unique case of traumatic atlanto-axial subluxation in a child with osteogenesis imperfecta associated with bilateral femoral fractures. The management is discussed. Atlanto-axial dislocation occurring with associated osteogenesis imperfecta is very rare. There have been no previous reported cases. A 15-month-old girl with osteogenesis imperfecta sustained a traumatic atlanto-axial dislocation. The child was followed-up through presentation, diagnosis, management and post-discharge. The initial diagnosis was confirmed with a CT scan. The patient was treated conservatively with a halo-traction for 4 weeks followed by a halo jacket for a further 4 weeks. Both appliances were fitted under general anaesthetic. An anatomical reduction was achieved. There was no neurological deficit at any stage. The child has had a successful outcome. She is asymptomatic with a full range of movement at the atlanto-axial joints at 9 months. In conclusion, this paper records our management of this rare problem.

Keywords

Atlanto-axial dislocationOsteogenesis imperfectaBilateral femoral fracturesHalo-tractionConservative treatment

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.West Middlesex University Hospital NHS TrustMiddlesexUK
  2. 2.Nuffield Orthopaedic HospitalOxfordUK