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Traumatic atlantoaxial rotatory dislocation and displaced ossiculum terminale epiphysiolysis treated with a halo device: a case report

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Abstract

Introduction

The horizontal synchondroses of the infant axis are biomechanical weak regions in trauma.

Case

We report the case of a 6-year-old girl who presented with delayed atlantoaxial dislocation and displaced ossiculum terminale epiphysiolysis after a fall from a tree.

Treatment

The patient was treated with halo traction for 3 days after which a CT scan showed normal position of the C1/C2 joint, and an acceptable position of the ossiculum terminale whereafter a halo brace was applied. Because of delayed union on CT scans, the treatment was prolonged to a total of 21 weeks.

Result

At final follow-up 26 months after halo brace removal, the patient demonstrated normal range of movement of the neck on clinical examination and radiographs of the cervical spine including lateral flexion/extension radiographs showed no sign of instability of the atlantoaxial joint.

Discussion

Conservative treatment with a halo device versus surgical treatment is discussed.

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Acknowledgments

We would like to thank Karl Erik Jensen, MD, DMSc, Department of Radiology, Rigshospitalet-Blegdamsvej, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen.

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Authors and Affiliations

  1. Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, 2600, Glostrup, Denmark

    Jonas Walbom

  2. Department of Orthopaedic Surgery, Spine Unit, Rigshospitalet-Blegdamsvej, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Anders Kruse

Authors
  1. Jonas Walbom
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  2. Anders Kruse
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Correspondence to Jonas Walbom.

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Jonas Walbom and Anders Kruse state that there are no conflicts of interest.

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Walbom, J., Kruse, A. Traumatic atlantoaxial rotatory dislocation and displaced ossiculum terminale epiphysiolysis treated with a halo device: a case report. Childs Nerv Syst 32, 1321–1325 (2016). https://doi.org/10.1007/s00381-016-3025-2

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  • DOI: https://doi.org/10.1007/s00381-016-3025-2

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