Sesia Sergio B, Prüfer Friederike, Walther Michael, Studer Daniel
Department of Pediatric Surgery, University Children's Hospital (UKBB), Basel, Switzerland.
Department of Paediatric Radiology, University Children's Hospital, Basel, Switzerland.
BMJ Case Rep. 2017 Jan 10;2017:bcr2016214472. doi: 10.1136/bcr-2016-214472.
A 2-year-old girl fell off a bunk bed onto a parquet floor. She immediately reported neck pain and presented with muscle spasm and limited motion of the cervical spine (C-spine). Plain X-rays of the C-spine showed no osseous lesion. Owing to persisting pain and limited motion in the neck, MRI of the C-spine was obtained which revealed intact ligaments and cervical spinal cord, as well as soft tissue swelling in front of the anterior arch of the atlas. Subsequent CT of the C-spine confirmed a complete, undisplaced fracture of the anterior arch of the atlas (Gehweiler type I fracture). A Minerva cast was applied for 2 months, followed by a soft cervical collar. Persistent neck pain and limited range of motion of the neck after a fall may be indicative of atlas fracture that should be ruled out by CT.
一名2岁女童从双层床跌落至镶木地板上。她当即称颈部疼痛，伴有肌肉痉挛及颈椎活动受限。颈椎X线平片未显示骨质病变。由于颈部疼痛持续且活动受限，遂行颈椎MRI检查，结果显示韧带及颈髓完整，同时寰椎前弓前方软组织肿胀。随后的颈椎CT证实寰椎前弓完全性、无移位骨折（Gehweiler I型骨折）。应用密涅瓦石膏固定2个月，之后佩戴软质颈托。跌倒后持续的颈部疼痛及颈部活动范围受限可能提示寰椎骨折，应通过CT排除。
