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Traumatic atlantoaxial subluxation in children
J D de Beer1, E B Hoffman, C F Kieck
1Red Cross Children's Hospital, Cape Town, South Africa.
Journal of Pediatric Orthopedics
|May 1, 1990
Summary
Traumatic atlantoaxial subluxation in children, often from accidents, can cause neurological issues. Prompt treatment of this neck injury leads to positive outcomes.
Area of Science:
- Pediatric Traumatology
- Orthopedic Surgery
- Neurosurgery
Background:
- Atlantoaxial subluxation (AAS) is a rare but serious condition affecting the upper cervical spine.
- Traumatic AAS without associated factors like congenital anomalies or inflammation presents unique diagnostic and management challenges in pediatric patients.
Observation:
- Four pediatric cases of traumatic atlantoaxial subluxation (AAS) without rotatory component, congenital anomaly, or inflammatory cause were identified.
- Mechanisms of injury included motor vehicle accidents (pedestrian) and a rugby-related neck injury.
- Neurological deficits were observed in two patients, directly linked to the AAS.
Findings:
- Reduction and stabilization of the atlantoaxial subluxation led to the resolution of neurological signs in affected patients.
- Conservative management was successful in three cases, while one case required operative intervention.
- All four pediatric patients achieved a satisfactory outcome following treatment for traumatic AAS.
Implications:
- Highlights the importance of considering traumatic AAS in pediatric neck injuries, even without typical risk factors.
- Demonstrates the effectiveness of both conservative and operative management strategies for pediatric traumatic AAS.
- Emphasizes the potential for full neurological recovery with timely diagnosis and appropriate intervention for pediatric AAS.