Panczykowski David, Nemecek Andrew N, Selden Nathan R
Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.
J Neurosurg Pediatr. 2010 Feb;5(2):200-3. doi: 10.3171/2009.9.PEDS09202.
In this report, the authors describe the case of a 3-year-old child with a traumatic Type III odontoid fracture. To their knowledge, this is the first reported case of a true Type III odontoid fracture with atlantoaxial rotatory subluxation in a child. The patient presented with pain and had resisted manipulation of the neck following a motor vehicle crash. Plain cervical radiographs revealed an odontoid fracture, which was confirmed by CT imaging. The left lateral mass of C-1 was rotated anterior to that of C-2 with the displaced odontoid process acting as the pivot point of rotation. The C1-2 alignment was normalized, and the C-2 fracture was reduced completely. The regional anatomy and mechanism of injury, radiographic diagnosis, and management of cervical spine injuries in children are discussed.
在本报告中，作者描述了一名3岁儿童患有创伤性III型齿状突骨折的病例。据他们所知，这是首次报道的儿童真性III型齿状突骨折合并寰枢椎旋转半脱位的病例。该患者在机动车碰撞后出现疼痛，且抗拒颈部手法操作。颈椎X线平片显示齿状突骨折，CT成像证实了这一诊断。C-1的左侧块向前旋转至C-2左侧块的前方，移位的齿状突作为旋转的枢轴点。C1-2对线恢复正常，C-2骨折完全复位。文中还讨论了儿童颈椎损伤的局部解剖结构、损伤机制、影像学诊断及治疗方法。
