Ottink KarstenD, van Middendorp Joost J, Kleinveld Sanne, Breemans Eric
Gelre Ziekenhuis, Afd. Orthopedische Chirurgie, Apeldoorn, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:B285.
An 8-year-old girl presented at the Accident & Emergency Department with torticollis and neck pain after falling on her head from a climbing frame. A computed tomography scan revealed a Gehweiler type 1 avulsion fracture combined with widening of an anatomically variant single anterior synchondrosis. The child was successfully treated with halter traction, painkillers and bed rest. Physicians should look out for upper cervical spine injury in children who sustained a cranial axial load injury. Differential diagnosis between pain-reactive muscular torticollis and atlantoaxial rotatory subluxation is essential. Children presenting with posttraumatic torticollis require a conventional or dynamic computed tomography scan.
