Traumatic atlantoaxial dislocation with a type III odontoid fracture: a rare and fatal injury

Abstract

Traumatic atlantoaxial dislocation with a dens fracture is very rare in children. In this case report, a 15-year-old woman presented at the emergency department after being hit by a motor vehicle as a bicyclist. CT scans showed a type III dens fracture with retropulsion of the posterior wall, resulting in significant stenosis of the spinal canal. A cervical transection and prevertebral hematoma were present. External immobilization can be applied conservatively. However, atlantoaxial dislocation may require surgical fixation to stabilize and prevent slippage. Here, posterior screw-rod fixation techniques can provide better results in terms of neurological outcomes, pain status and adverse events compared to other techniques. However, head and neck imaging should be performed to consider surgical intervention.