• C Münch, W Linhart, A Storck, L Papavero, J Windolf, J M Rueger, and D Briem.
• Zentrum für Operative Medizin, Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitäts-Klinikum Hamburg-Eppendorf. cmuench@uke.uni-hamburg.de
• Unfallchirurg. 2005 Nov 1;108(11):987-90.

AbstractCervical spine injuries are rare in children. They tend to occur predominantly in the region of atlanto-axial articulation. Even traumatic rotatory atlanto-axial subluxation (AAD) has been described in the literature, however, there is no consistent therapeutic protocol. We report on a 4 year old girl with an acute traumatic rotatory atlanto-axial subluxation treated with closed reduction and retention in a hard-collar. Control CT scans and physical examination after 6 weeks revealed an excellent outcome without any signs of recurrence. As there is a correlation between outcome and increasing length of the dislocation-therapy interval, optimal management of acute rotatory atlanto-axial subluxation depends on early diagnosis with plain radiography and CT scans. Timely diagnosed cases may be treated successfully with closed reduction and cervical immobilisation in a hard-collar. Failure to obtain reduction and recurrence are an appropriate indication for surgical intervention.

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