PubMed · 8111986
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V K Sonntag, C A Dickman. 1993. Craniocervical stabilization.. https://pubmed.ncbi.nlm.nih.gov/8111986/
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A case of an eight-year-old boy who had sustained both a fractured clavicle and rotatory atlanto-axial fixation is described. The last diagnosis was missed for four and a half months. The diagnosis was made in combination with cineroentgenography and computed tomography scanning. Conservative treatment with external traction was first attempted, after which the patient was operated twice with posterior fusion between C-1 and C-2. At six month follow-up the child was without pain, had neutral head holding and about two-thirds of normal rotation.
A case of atlantoaxial instability with a rare etiology in a boy of 7 years and 3 months is presented. Computerized tomography with three-dimensional reconstruction revealed avulsion of the ossiculum terminale (apical odontoid epiphysis). Developmental peculiarities and relevant disorders of the infantile upper cervical spine are discussed. Temporary posterior C1/C2 fusion and transdental screw fixation of the ossiculum terminale were attempted in order to stabilize C1/C2 and avoid permanent fusion. After removal of the dorsal implants, the transdental screw broke, the instability recurred and a permanent atlantoaxial fusion had to be performed.