Traumatic atlantoaxial dislocation with Hangman fracture

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Trauma Care

Background:

• Traumatic bilateral atlantoaxial dislocations are rare.
• Hangman fractures (C2-spondylolisthesis) comprise 4-7% of cervical fractures, often involving C1-C2 patterns.
• No prior reports exist of traumatic C2-spondylolisthesis with C1-C2 rotatory dislocation.

Observation:

• A 26-year-old male sustained a C2-spondylolisthesis and bilateral C1-C2 rotatory subluxation in a motor vehicle collision.
• The complex injury did not fit existing classification systems.
• Initial management involved halo crown and vest stabilization.

Findings:

• Open reduction and posterior stabilization of C1, C2, and C3 were performed for persistent subluxation.
• Radiographic fusion was achieved 16 months postoperatively.
• The patient returned to his work as a plumber.

Implications:

• This case highlights an unclassifiable traumatic C1-C2 injury.
• A treatment protocol of halo stabilization followed by posterior segmental fixation can yield successful outcomes.
• Further research is needed to refine classification and treatment for such complex injuries.