School of Medicine, Uniformed Services University, Bethesda, Maryland.
Department of Orthopaedic Surgery, Tripler Army Medical Center, Honolulu, Hawaii.
JBJS Case Connect. 2023 May 19;13(2). doi: e22.00656. eCollection 2023 Apr 1.
A 4-year-old girl sustained a traumatic atlantoaxial rotatory subluxation. She presented at the treating facility 8 months after injury with cervical deformity, neck pain, gait instability, and decreased cervical motion. Her delay in presentation was partially because of international Corona Virus of 2019 (COVID-19) travel restrictions. The case was successfully treated with halo traction, followed by halo vest immobilization.
Chronic atlantoaxial rotatory fixation can be treated nonsurgically with closed reduction and halo traction, but is associated with operative risks. Optimal pin placement is challenging in the pediatric skull and may be improved with a preoperative or intraoperative computed tomography (CT) scan.
一名 4 岁女孩发生创伤性寰枢椎旋转半脱位。她在受伤后 8 个月因颈椎畸形、颈部疼痛、步态不稳和颈椎活动度降低到就诊医院就诊。她的就诊延迟部分是由于 2019 年国际冠状病毒（COVID-19）旅行限制。该病例通过 halo 牵引成功治疗，随后 halo 背心固定。
慢性寰枢椎旋转固定可以通过闭合复位和 halo 牵引进行非手术治疗，但存在手术风险。在小儿颅骨中，最佳的针放置位置具有挑战性，术前或术中计算机断层扫描（CT）扫描可能会有所改善。
