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Delayed Presentation of Pediatric Atlantoaxial Subluxation with Cervical Myelopathy After Clavicle Fracture: A Case
Sang Bum Kim1, Hyung-Jin Chung, Seung Hoo Lee
1Department of Orthopaedic Surgery, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, South Korea.
Case:
A 10-year-old girl developed persistent torticollis after surgery for a clavicular fracture. This condition was initially misattributed to muscle spasms and hardware irritation, leading to a delayed diagnosis. Eventually, the patient developed cervical myelopathy, and subsequent evaluation revealed atlantoaxial rotatory subluxation (AARS) equivalent to Fielding and Hawkins type III, ultimately requiring emergency surgical fusion.
Conclusion:
Persistent torticollis after pediatric clavicle fractures warrants careful evaluation for possible AARS. Awareness of this rare coexistence and timely imaging are essential to avoid invasive surgery and serious complications.
