Abstract
IntroductionAtlantoaxial rotatory subluxation is rarely caused by trauma in adults. Usually, the treatment of choice is traction using Halo/Gardner-Wells fixation devices for up to six weeks.Case presentationWe present the case of a 19-year-old Caucasian woman with traumatic atlantoaxial subluxation. Early reduction three hours after trauma and immobilization using only a soft collar were performed and yielded very good clinical results.ConclusionIn the adult population, atlantoaxial subluxation is a rare condition but is severe if untreated. Early treatment implies a non-surgical approach and a good outcome. Conservative treatment is the recommended first step for this condition.
Highlights
Atlantoaxial rotatory subluxation is rarely caused by trauma in adults
Atlantoaxial rotatory subluxation is frequently observed in children and in patients with rheumatic arthritis, but rarely occurs traumatically in adults [1]
We present the case of a patient with traumatic atlantoaxial subluxation in which early reduction, three hours after trauma and immobilization using only a soft collar were performed and yielded very good clinical results
Summary
Atlantoaxial rotatory subluxation is frequently observed in children and in patients with rheumatic arthritis, but rarely occurs traumatically in adults [1]. We present the case of a patient with traumatic atlantoaxial subluxation in which early reduction, three hours after trauma and immobilization using only a soft collar were performed and yielded very good clinical results. Case Presentation While driving a van and wearing a seatbelt, a 19-yearold Caucasian woman, was involved in a head-on vehicle collision (speed about 40 km/hour), followed by a rearend hit from another vehicle. When rescue services arrived at the scene, the patient was found sitting in her car with her head immobilized in a left rotation. She. immobilized in a soft collar for six weeks. At a followup examination six weeks after the trauma, the pain and paresthesia in the left arm had receded completely and the patient had a full range of motion. A follow-up MRI of the cervical spine showed only slight persistent atlantoaxial rotational displacement of C1/2
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