Koppe D, Markart M, Ertel W
Klinik für Unfallchirurgie und Orthopädie, Unfallkrankenhaus, Warener Straße 7, 12683, Berlin, Deutschland.
Unfallchirurg. 2014 Jun;117(6):568-71. doi: 10.1007/s00113-013-2430-1.
Injuries of the cervical spine in adolescents only occur in 0.2 % of cases. Due to the mismatch of size of the head in comparison to the relatively weakly developed neck muscles at this age, the cranial section is more vulnerable to injuries of any kind compared to the lower sections of the cervical spine. In children isolated ligament trauma is more common than fractures due to the relatively good bone structure combined with a lower bone density but the risk for fractures increases with the age of the patient. Atlantoaxial dislocation (AAD) in children is a very rare mostly ligamentous injury. A differentiation is made between traumatic AAD and the much more common non-traumatic AAD described in the literature. Although the cause is still unknown different risk factors have been isolated that seem to increase the risk for non-traumatic AAD. The following article presents guidelines for the diagnosis and treatment of this rare type of injury and also describes the case of a 19-year-old female who presented at the emergency department with an AAD without a history of trauma. After successful closed repositioning the neck was stabilized in a semi-rigid cervical collar for 6 weeks.
青少年颈椎损伤仅占所有病例的0.2%。由于该年龄段头部与相对发育较弱的颈部肌肉在尺寸上不匹配，与颈椎下段相比，颅段更容易受到各种损伤。在儿童中，由于相对良好的骨骼结构和较低的骨密度，孤立的韧带损伤比骨折更常见，但骨折风险会随着患者年龄的增长而增加。儿童寰枢椎脱位（AAD）是一种非常罕见的主要为韧带损伤的疾病。文献中对创伤性AAD和更为常见的非创伤性AAD进行了区分。尽管病因尚不清楚，但已发现不同的风险因素似乎会增加非创伤性AAD的风险。以下文章介绍了这种罕见损伤类型的诊断和治疗指南，并描述了一名19岁女性的病例，该女性因无创伤史的AAD就诊于急诊科。成功进行闭合复位后，颈部用半刚性颈托固定6周。
