Traumatic C1–2 rotatory subluxation with dens and bilateral articular facet fractures of C2
| Autor: | Hyuk-Jin Jang, Jong-Beom Park, Dong-Gune Chang |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Fractures Multiple Joint Dislocations 03 medical and health sciences dens fracture 0302 clinical medicine medicine Humans Clinical Case Report Subluxation 030222 orthopedics Neck pain Articular facet business.industry General Medicine Middle Aged medicine.disease Cervical spine Surgery Skull medicine.anatomical_structure traumatic C1–2 rotatory subluxation Cervical Vertebrae Spinal Fractures Accidental Falls bilateral articular facet fracture Plain radiographs medicine.symptom business Alcoholic Intoxication 030217 neurology & neurosurgery Research Article Cervical vertebrae Torticollis |
| Zdroj: | Medicine |
| ISSN: | 0025-7974 |
| DOI: | 10.1097/md.0000000000010189 |
| Popis: | Rationale: To the best of our knowledge, this is an extremely rare case of traumatic C1–2 rotatory subluxation associated with multiple C2 fractures. Patient concerns: We report the case of a 63-year-old man with type 2 traumatic C1–2 rotatory subluxation (Fielding and Hawkins classification) associated with type III dens (Anderson and D’Alonzo classification) and bilateral articular facet fractures of C2. This injury occurred as a result of falling down in a drunken state. The patient complained of neck pain and mild degree of torticollis but did not show any neurologic abnormalities. Diagnoses: Plain radiographs of cervical spine showed extensive soft tissue swelling, a fracture fragment, disruption of spinolaminar line at C1–2 level, and bony overlapping of right side lateral joint of C1–2. Two- and three-dimensional reconstructed computed tomography scans clearly demonstrated complicated C1–2 combined injury. The atlantodental interval was normal. Intervention: By skull traction and derotation, closed reduction of C1–2 rotatory subluxation with a type III dens and bilateral articular facet fractures of C2 was successfully achieved. He was managed with halovest fixation for 3 months. Outcomes: At the 1-year follow-up visit solid fusion and improvement of clinical symptoms were achieved without C1–2 instability. Lessons: Despite traumatic C1–2 rotatory subluxation associated with multiple C2 fractures, trial of closed reduction should be considered as the first choice of treatment so as to preserve C1–2 motion. |
| Databáze: | OpenAIRE |
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