A Case of Traumatic Atlantoaxial Dislocation Treated by Manual Reduction under General Anesthesia

Abstract

Traumatic atlantoaxial dislocation is comparatively rare. We present a case of atlantoaxial rotatory dislocation fracture in a 53-year-old male, who had fallen down stairs under the influence of alcohol and struck his posterior neck region. He was transferred to our emergency department. At initial examination he was alert and neurologically normal, but his head was fixed in the cock robin position. Cervical CT showed atlantoaxial rotator dislocation with left C2 superior articular process fracture. Glisson's traction was performed initially, followed by skeletal traction. Because dislocation remained, manual reduction was performed under general anesthesia. Thereafter, we applied a halo-vest for one month, followed by use of a Philadelphia collar. Four months after trauma, there is no limitation in the range of neck motion.