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Erschienen in:
29.01.2016 | Case Report
Traumatic atlantoaxial rotatory dislocation and displaced ossiculum terminale epiphysiolysis treated with a halo device: a case report
Erschienen in: Child's Nervous System | Ausgabe 7/2016
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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.