Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Narita, Japan.
Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Tokyo, Japan.
JBJS Case Connect. 2021 Feb 17;11(1):01709767-202103000-00024. doi: e20.00675.
A 42-year-old woman presented with a severe neck pain and torticollis due to uncertain etiology. Because her radiographs and computed tomography revealed atlantoaxial rotatory fixation (AARF) that is an extremely rare condition in the adult population, a nonsurgical treatment was initially applied. Because 3 weeks of indirect traction failed, closed reduction was performed under general anesthesia at 2 months after onset, and her symptoms markedly improved without any complications and recurrence.
Closed reduction under general anesthesia for nontraumatic AARF in adult patients might be an effective treatment option, even for chronic cases or intractable cases by traction treatment.
一名 42 岁女性因病因不明出现严重颈部疼痛和斜颈。由于她的 X 线片和计算机断层扫描显示寰枢椎旋转固定(AARF),这在成人中是一种极其罕见的情况,因此最初采用非手术治疗。由于 3 周的间接牵引失败,在发病后 2 个月在全身麻醉下进行了闭合复位,她的症状明显改善,没有任何并发症和复发。
对于成人非创伤性 AARF,全身麻醉下闭合复位可能是一种有效的治疗选择,即使对于牵引治疗的慢性或难治性病例也是如此。