Atlanto-axial dislocation complicating a type II odontoid fracture. Reduction and final fixation

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• 作者：G. Riouallon^a ; ^b ; ^{g.riouallon@gmail.com" class="auth_mail} ; ^{griallou@hpsj.fr" class="auth_mail} ; H. Pascal-Moussellard^a ; ^b
• 关键词：Atlanto-axial ; C1-C2 ; Cervical trauma ; Odontoid fractures ; Posterior dislocation ; Cervical traction ; Vaccaro
• 刊名：Orthopaedics Traumatology: Surgery Research
• 出版年：May 2014
• 年：2014
• 卷：100
• 期：3
• 页码：341-345
• 全文大小：1550 K

文摘

A case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture is reported. This is a rare case of traumatic posterolateral C1-C2 dislocation associated with odontoid fracture. Its management is discussed. A traumatic dislocation of atlanto-axial joint associated with an odontoid fracture remains a rare injury. No case of posterior dislocation has been reported so far in the literature with this type of management. The case is of a 25 year-old-man with a primary atlanto-axial posterolateral dislocation associated with a type II displaced odontoid fracture without any neurological complication. The patient underwent gentle traction during 24 hours with a halo frame. An incomplete reduction was achieved. Two days later, a complete reduction was obtained thanks to a preoperative manual traction maintained by a Mayfield (R) modified skull clamp. Anterior C1-C2 fixation was performed according to Vaccaro's technique. The patient wore a cervical collar and underwent physiotherapy during three months. To our best knowledge, this case represents the first traumatic atlanto-axial dislocation associated with an odontoid fracture which was treated through retropaharyngeal approach. This had been rendered possible thanks to the final reduction maneuver in extension.