Abstract
C1-2 rotatory subluxation is more commonly seen in children compared to in adults. It often has a history of respiratory tract infection, cervical trauma, and recent history of surgery of the head or neck. A 6-year-old boy presented to us with complaints of insidious onset of progressive deformity of the neck since the past 3 months. On examination, the patient had a classic "cock robin" deformity with his left head tilt and right-sided chin rotation. There was tenderness and spasm of the left sternocleidomastoid muscle. Radiologically, the child had unilateral C1-C2 facetal dislocation. There were associated abnormalities consisting of unilateral occiputoatlantal fusion and C2-C3 fusion. Magnetic resonance imaging (MRI) showed C1-C2 subluxation with kyphotic deformity the apex of which was impinging on the brainstem. The patient was put on skull traction with Crutchfield Tongs with progressively increasing weights for 1 week and serial X-rays were taken. Computed tomography (CT) scan was repeated at the end of 1 week which showed no improvement. C1-C2 open reduction and fusion was done. Post-operative period was uneventful. He improved on serial follow-ups. At follow-up at 18 months, the child remains comfortable, is going to school and doing all indoor and outdoor activities. His posture continues to be balanced. Radiologically, C1-C2 joint shows signs of a solid fusion. A thorough history taking and a meticulous clinical examination if important for evaluation of torticollis in a child. Proper imaging helps in confirming the diagnosis and grading the severity. Prompt treatment is necessary for getting a good outcome.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.