Related Experiment Videos
Grisel's syndrome.
1Division of Orthopaedic Surgery, Milton S. Hershey Medical Center, Hershey, PA 17033.
Clinical Orthopaedics and Related Research
|March 1, 1989
Summary
Grisel's syndrome, a C1-C2 joint misalignment due to infection, is treated with antibiotics and traction. Immobilization type depends on injury severity, with surgery for persistent instability.
Area of Science:
- Orthopedics
- Infectious Diseases
- Pediatric Spine Surgery
Background:
- Grisel's syndrome involves C1-C2 subluxation linked to head/neck infections.
- A pharyngeal vascular plexus facilitates direct infection spread to the C1-C2 articulation.
- Septic exudates cause ligament damage, leading to atlantoaxial subluxation.
Purpose of the Study:
- To outline the pathophysiology and treatment of Grisel's syndrome.
- To apply Fielding's classification for rotary subluxation to guide treatment.
- To recommend specific immobilization strategies based on injury biomechanics.
Main Methods:
- Review of anatomical and biomechanical data.
- Classification of rotary subluxation using Fielding's scheme.
- Correlation of injury extent with recommended immobilization (collar, brace, halo).
Main Results:
- Treatment involves antibiotics and traction for subluxation reduction.
- Immobilization choice is stratified by Fielding type: Type I (soft collar), Type II (Philadelphia collar/SOMI brace), Type III (halo).
- Stability assessed via flexion-extension X-rays after 6-8 weeks.
Conclusions:
- Appropriate immobilization is crucial for ligament healing in Grisel's syndrome.
- Fielding's classification aids in tailoring treatment to injury severity.
- Arthrodesis is indicated for residual instability post-immobilization.