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Related Experiment Videos

Grisel's syndrome.

F T Wetzel1, H La Rocca

  • 1Division of Orthopaedic Surgery, Milton S. Hershey Medical Center, Hershey, PA 17033.

Clinical Orthopaedics and Related Research
|March 1, 1989
PubMed
Summary
This summary is machine-generated.

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.

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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.

Related Experiment Videos

  • 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.