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Atlantoaxial Rotatory Displacement

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Other Names


Background

  • A common cause of childhood torticullis
  • Subluxation/dislocation injury at C1-2 that has been reported to occur after a Clavicle Fracture
  • The C1 vertebral body is rotated in relation to the C2 vertebral body

Epidemiology

  • Most commonly seen ages 6-10 (need citation)

Pathophysiology

Etiology

  • Infection (most common, need citation)
  • Sternocleidomastoid muscle spasm
  • Neoplasm
  • Medication side effect

Risk Factors


Differential Diagnosis


Clinical Features

  • The head will tilt towards the side of clavicle injury

Evaluation

  • Radiographs
    • Standard views
    • Difficult to see and often missed initially
    • Consider flexion-extension films
  • CT
    • Helpful to better evaluate subluxation or dislocation

Classification


Management

Nonoperative

  • Upon initial diagnosis, place is soft cervical spine collar
  • Consult pediatric spine surgeon
  • Patients can often be successfully managed nonoperatively
    • Soft cervical collar
    • Head halter traction
  • May spontaneously reduce

Operative

  • Delayed diagnosis more likely to require surgical intervention
  • Technique
    • C1-C2 Fusion

Return to Play


Complications


See Also


References


Created by:
John Kiel on 27 November 2019 16:28:58
Authors:
Last edited:
29 November 2019 20:04:57
Categories: