Posttraumatic Atlantoaxial Rotatory Dislocation in a Healthy Adult Patient: A Case Report and Review of the Literature

Case Reports in Orthopedics, 2012 · DOI: 10.1155/2012/183581 · Published: September 30, 2012

Simple Explanation

Atlantoaxial rotatory dislocation (AARD) is a rare complication in adults usually leading to pain, spinal cord injury, or death. The patient was found to have a severe torticollis with his head rotated to the left side and tilted toward the right side in a “cock-robin” position, muscles spasms, painful limitation of motion, and inability to turn the head to the right side. Early diagnosis, immobilisation, and surgical fusion and arthrodesis were performed, resolving cervical pain and torticollis, with the patient remaining neurologically intact.

Study Duration

3-year followup

Participants

A 27-year-old male

Evidence Level

Case Report

Key Findings

1
Initial radiographic evaluation can be negative in posttraumatic AARD cases.
2
CT scan is crucial for diagnosing AARD, showing atlanto-dental interval, axial rotation, and asymmetry of lateral masses.
3
MRI is essential to rule out neurovascular injuries and ligamentous ruptures.

Research Summary

This case report describes a rare instance of posttraumatic atlantoaxial rotatory dislocation (AARD) in a neurologically intact adult male following a motor vehicle accident. The patient presented with severe torticollis and limited neck motion, prompting a CT scan that revealed the dislocation, followed by MRI to assess ligamentous injuries. Early posterior occipito-cervical stabilization and arthrodesis were performed, leading to resolution of symptoms and a stable fusion at the 3-year follow-up, highlighting the importance of prompt diagnosis and surgical intervention.

Practical Implications

Diagnostic vigilance

AARD should be suspected in patients with torticollis and cervical pain, even with negative initial radiographs.

Imaging Importance

CT scans are the gold standard for diagnosing AARD, supplemented by MRI to assess soft tissue and vascular injuries.

Early Intervention

Early reduction and fusion are recommended to prevent neurologic deterioration and vertebral artery injury.

Posttraumatic Atlantoaxial Rotatory Dislocation in a Healthy Adult Patient: A Case Report and Review of the Literature

Simple Explanation

Key Findings

Research Summary

Practical Implications

Diagnostic vigilance

Imaging Importance

Early Intervention

Study Limitations

Your Feedback

Was this summary helpful?

Posttraumatic Atlantoaxial Rotatory Dislocation in a Healthy Adult Patient: A Case Report and Review of the Literature

Simple Explanation

Key Findings

Research Summary

Practical Implications

Diagnostic vigilance

Imaging Importance

Early Intervention

Study Limitations

Your Feedback

Was this summary helpful?