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Intentional avulsion fracture of the second cervical vertebra in a hypotonic child

Resmiye Oral1, Riad Rahhal, Huda Elshershari

  • 1Child Protection Program, USA. resmiye-oral@uiowa.edu

Pediatric Emergency Care
|May 23, 2006
PubMed

Insights

A rare cervical fracture in a young child with hypotonia was diagnosed after a fall. This case highlights the importance of considering inflicted injuries in vulnerable children with developmental delays.

Area of Science:

  • Pediatric Orthopedics
  • Child Abuse Pediatrics
  • Pediatric Traumatology

Background:

  • Cervical fractures are uncommon in children, typically resulting from high-impact trauma.
  • Children with developmental delay and chronic hypotonia may present unique diagnostic challenges.

Observation:

  • A 4-year-old child with developmental delay and hypotonia presented with irritability and difficulty walking.
  • Radiographic imaging revealed an avulsion fracture of the second cervical vertebra (C-2).

Findings:

  • Neck MRI confirmed the C-2 avulsion fracture and associated interspinal ligament injury between C-1 and C-2.
  • The injury mechanism involved the child being thrown onto a bed, suggesting inflicted trauma.

Implications:

  • This is the first reported pediatric case of this specific cervical fracture in a hypotonic child.
  • Highlights the need for vigilance in diagnosing inflicted injuries, even in children with pre-existing conditions.
  • Emphasizes the role of advanced imaging in identifying subtle pediatric cervical spine injuries.

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