• Maximilian Faschingbauer, Arndt P Schulz, Klaus Seide, and Christian Jürgens.
• Department of Trauma and Orthopedic Surgery, BG Trauma Hospital Hamburg, Hamburg, Germany. m.faschingbauer@apschulz.de.
• Eur J Trauma Emerg S. 2008 Oct 1;34(5):515.

AbstractLarge studies about the management of pediatric patients with unstable flexion-distraction injuries of the midcervical spine are rare. We present the case of a 12-year-old girl who sustained a cervical spinal injury with unilateral facet dislocation and discuss details and problems of diagnostic procedures and treatment in the light of the recent literature. The management and pitfalls of a unilateral facet dislocation in a child are summarized. After initial reposition, a multisegmental instability with neurology developed. Although distraction-flexion cervical spine injuries are common in adults and often occur with concomitant neurological sequelae, they also can occur in the pediatric population. In conclusion, an MRI seems advisable. A treatment of postoperative malalignment with reposition via a halo-fixator cannot be recommended. Repositioning is possible but was lost when the fixator was removed. Comparing the historic and recent literature there is only weak evidence overall, nevertheless a ventral fusion seems to be the treatment option of choice.

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