[Traumatic occipitocervical and atlantoaxial dislocation with clivus fracture in a child. Case report]

Area of Science:

• Pediatric Neurosurgery
• Orthopedic Surgery
• Trauma Care

Background:

• Craniovertebral junction lesions in children have historically low survival rates and significant neurological disability.
• Paediatric patients are uniquely susceptible due to anatomical factors like ligamentous laxity.
• Limited data exists on survival and outcomes for paediatric craniovertebral junction injuries compared to adults.

Observation:

• An 8-year-old male presented with occipitocervical and atlantoaxial dislocation, clivus fracture, brain edema, and subarachnoid hemorrhage.
• Initial management involved a halo vest without traction.
• Surgical intervention included C1-C2 trans-articular screws, occipitocervical fixation, and C1-C2 fusion with bone graft and wires.

Findings:

• The surgical procedure was performed without complications.
• The patient experienced a positive recovery, returning to school and achieving self-sufficiency.
• This case demonstrates the potential for successful surgical management of severe craniovertebral junction injuries in children.

Implications:

• Improved surgical techniques and pre-hospital care are contributing to reduced mortality rates for these injuries.
• Successful surgical outcomes can lead to significant functional recovery and improved quality of life for paediatric patients.
• Further research into paediatric craniovertebral junction injury management is warranted to optimize treatment strategies.