Singla Raghav, Manjunath Niveditha, Sharma Ravi, Mishra Shashwat
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi.
Int J Spine Surg. 2020 Feb 29;14(1):46-52. doi: 10.14444/7006. eCollection 2020 Feb.
Atlantoaxial rotatory dislocations (AARDs) are common in the pediatric population and rarely seen in adults. We describe a case of neglected AARD and subsequent management. A 25-year-old man developed a Fielding type 1 AARD following a road traffic accident. He was managed conservatively for 1.5 months before being referred to us. The patient underwent surgery 1.5 months after the accident. Closed reduction failed and C1-2 fixation with the Harms technique was performed after intraoperative reduction resulting in correction of deformity. Delay of treatment makes intraoperative reduction more difficult and increases the possibility of the chronic permanent change of neck muscles and ligaments. Hence, a high index of suspicion with a thorough clinical examination and judicious use of radiological investigations is paramount to the appropriate management of such cases.
寰枢椎旋转性半脱位（AARDs）在儿童中很常见，在成人中很少见。我们描述了一例被忽视的AARD病例及后续治疗。一名25岁男性在道路交通事故后发生了菲尔德1型AARD。他在被转诊至我们这里之前接受了1.5个月的保守治疗。患者在事故发生1.5个月后接受了手术。闭合复位失败，术中复位后采用哈姆斯技术进行C1-2固定，从而纠正了畸形。治疗延迟会使术中复位更加困难，并增加颈部肌肉和韧带发生慢性永久性改变的可能性。因此，高度的怀疑指数、全面的临床检查以及合理使用影像学检查对于此类病例的恰当处理至关重要。
