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Torticollis of a specific C1 dislocation with split atlas
Atsuko Tachibana1, Hideaki Imabayashi, Yoshiyuki Yato
1Department of Orthopedics, National Defense Medical College, Saitama, Japan. hotchild53@hotmail.co.jp
Spine
|May 28, 2010
Summary
A rare case of pediatric torticollis was caused by a congenital split atlas. Closed reduction using skull traction successfully treated the condition, avoiding surgery and restoring full neck motion.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Congenital Anomalies
Background:
- Torticollis in children after minor trauma is often due to atlantoaxial rotatory fixation.
- Computed tomography (CT) is typically used for diagnosis.
- A congenital split atlas is a rare cause of torticollis.
Observation:
- A 3-year-old girl presented with torticollis after a fall.
- CT imaging revealed no C1-C2 rotatory dislocation but showed a split atlas with atypical rotation.
- The split atlas presented with posterior arch malalignment and facet joint asymmetry.
Findings:
- A congenital split atlas with C1 rotation caused the pediatric torticollis.
- Closed reduction with skull traction was performed under general anesthesia.
- Intraoperative 3D scanning confirmed successful repositioning, avoiding open reduction.
Implications:
- This case highlights a novel cause of torticollis in pediatric patients.
- Successful closed reduction of a split atlas offers a non-surgical treatment option.
- Early diagnosis and intervention can lead to full recovery of neck motion.
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