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Updated: Dec 12, 2025

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Displaced odontoid synchondrosis fracture with C1-2 dysjunction in an 18-month-old child: challenges and solutions

Pravin Salunke1, Parth Jani1, Sushanta K Sahoo2

  • 1Neurosurgery, PGIMER, Chandigarh, Sector 12, Chandigarh, 1600l2, India.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|August 12, 2020
PubMed

Insights

Odontoid synchondral fractures in young children are unstable and require surgery. This case highlights cautious traction and fixation techniques for successful pediatric spinal stabilization.

Area of Science:

  • Pediatric Orthopedics
  • Neurosurgery
  • Spinal Surgery

Background:

  • Odontoid synchondral fractures with displacement/angulation in young children present significant instability.
  • The small, soft bones in this age group pose challenges for surgical instrumentation and manipulation due to poor pull-out strength.

Observation:

  • An 18-month-old child with an odontoid synchondral fracture experienced neurological worsening after minimal traction, revealing C1-2 dysjunction.
  • Surgical intervention involved fixation of the C1-2 facets using a short plate and facetal screws.

Findings:

  • The case demonstrates that even minimal traction can exacerbate instability in pediatric odontoid fractures.
  • Successful surgical fixation of the C1-2 facets was achieved using specialized instrumentation.

Implications:

  • Traction in pediatric spinal trauma must be applied with extreme caution to prevent distraction injuries.
  • Meticulous intraoperative planning and execution are crucial for successful realignment and fixation, minimizing risks of hardware failure or further injury.
Abstract

Keywords:
C1–2 dysjunctionOdontoid fracturesPediatric spineSynchondrosisUnstable spine

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