Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report

The occurrence of atlantoaxial rotatory subluxation is fairly uncommon; however, it is more common to be encountered in the paediatric population, typically seen after a retropharyngeal inflammation or after a minor trauma. Ligamentous laxity, shallower and more horizontally oriented facet joints...

Full description

Bibliographic Details
Main Authors:	Ab. Wahid, Hazwan, Kow, Ren Yi, Mor Japar Khan, Ed Simor Khan, Komahen, Colin
Format:	Article
Language:	English
Published:	Kulliyyah of Medicine, International Islamic University Malaysia 2017
Subjects:	RD701 Orthopedics
Online Access:	http://irep.iium.edu.my/64038/ http://irep.iium.edu.my/64038/ http://irep.iium.edu.my/64038/1/64038_TRAUMATIC%20PEDIATRIC%20ATLANTOAXIAL.pdf

id	iium-64038
recordtype	eprints
spelling	iium-640382018-07-02T01:44:11Z http://irep.iium.edu.my/64038/ Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report Ab. Wahid, Hazwan Kow, Ren Yi Mor Japar Khan, Ed Simor Khan Komahen, Colin RD701 Orthopedics The occurrence of atlantoaxial rotatory subluxation is fairly uncommon; however, it is more common to be encountered in the paediatric population, typically seen after a retropharyngeal inflammation or after a minor trauma. Ligamentous laxity, shallower and more horizontally oriented facet joints especially at the C1-2 joint making them prone to have atlantoaxial subluxation or dislocation. If recognized early it can be successfully managed non-surgically before chronic inflammatory changes affect the ligaments and joint structure of the C1-2 complex. However, there is no standard treatment protocol as some authors like Nael et al and Haliasos and Norris recommended more invasive Halo skull traction. Thus, we report this case managed with less invasive Halter traction with no risk of pin site infections. We present the case of a 12-year-old Malay boy with traumatic atlantoaxial dislocation who came to us after he slipped and fell, presented with neck pain and torticollis to the left side but without other neurological deficits. A computed-tomography (CT) scan revealed an atlantoaxial rotation of 47 to the left without any signs of osseous lesions. MRI was also done and all ligaments were intact. The neck was then reduced by cautious rotation with Halter traction with the cervical spine in the neutral position with slight flexion thus avoiding harm by potential posttraumatic disc lesions. The patient was put on Halter traction for a total of one month. Post-traction revealed full range of motion of the neck without any tenderness, head and neck alignment restored to neutral position. In the children population, atlantoaxial subluxation is a rare condition but is severe if left untreated. Early treatment implies a non-surgical approach and a good outcome is observed in our case as well as reported by other authors. Kulliyyah of Medicine, International Islamic University Malaysia 2017-09-15 Article NonPeerReviewed application/pdf en http://irep.iium.edu.my/64038/1/64038_TRAUMATIC%20PEDIATRIC%20ATLANTOAXIAL.pdf Ab. Wahid, Hazwan and Kow, Ren Yi and Mor Japar Khan, Ed Simor Khan and Komahen, Colin (2017) Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report. The International Medical Journal Malaysia, 16 (Supp. 1). p. 43. ISSN 1823-4631 http://iiumedic.net/imjm/v1/download/Volume%2016%20No%201%20Supp%201/Abstract-Book-for-IMJM-final-v2-49.pdf
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD701 Orthopedics
spellingShingle	RD701 Orthopedics Ab. Wahid, Hazwan Kow, Ren Yi Mor Japar Khan, Ed Simor Khan Komahen, Colin Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report
description	The occurrence of atlantoaxial rotatory subluxation is fairly uncommon; however, it is more common to be encountered in the paediatric population, typically seen after a retropharyngeal inflammation or after a minor trauma. Ligamentous laxity, shallower and more horizontally oriented facet joints especially at the C1-2 joint making them prone to have atlantoaxial subluxation or dislocation. If recognized early it can be successfully managed non-surgically before chronic inflammatory changes affect the ligaments and joint structure of the C1-2 complex. However, there is no standard treatment protocol as some authors like Nael et al and Haliasos and Norris recommended more invasive Halo skull traction. Thus, we report this case managed with less invasive Halter traction with no risk of pin site infections. We present the case of a 12-year-old Malay boy with traumatic atlantoaxial dislocation who came to us after he slipped and fell, presented with neck pain and torticollis to the left side but without other neurological deficits. A computed-tomography (CT) scan revealed an atlantoaxial rotation of 47 to the left without any signs of osseous lesions. MRI was also done and all ligaments were intact. The neck was then reduced by cautious rotation with Halter traction with the cervical spine in the neutral position with slight flexion thus avoiding harm by potential posttraumatic disc lesions. The patient was put on Halter traction for a total of one month. Post-traction revealed full range of motion of the neck without any tenderness, head and neck alignment restored to neutral position. In the children population, atlantoaxial subluxation is a rare condition but is severe if left untreated. Early treatment implies a non-surgical approach and a good outcome is observed in our case as well as reported by other authors.
format	Article
author	Ab. Wahid, Hazwan Kow, Ren Yi Mor Japar Khan, Ed Simor Khan Komahen, Colin
author_facet	Ab. Wahid, Hazwan Kow, Ren Yi Mor Japar Khan, Ed Simor Khan Komahen, Colin
author_sort	Ab. Wahid, Hazwan
title	Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report
title_short	Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report
title_full	Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report
title_fullStr	Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report
title_full_unstemmed	Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report
title_sort	traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report
publisher	Kulliyyah of Medicine, International Islamic University Malaysia
publishDate	2017
url	http://irep.iium.edu.my/64038/ http://irep.iium.edu.my/64038/ http://irep.iium.edu.my/64038/1/64038_TRAUMATIC%20PEDIATRIC%20ATLANTOAXIAL.pdf
first_indexed	2023-09-18T21:30:49Z
last_indexed	2023-09-18T21:30:49Z
_version_	1777412498274648064

Traumatic pediatric atlantoaxial rotatory dislocation successfully reduced with 1 month total of halter traction: a case report

Similar Items