Traumatic atlanto-occipital dislocation in children.
J Am Acad Orthop Surg
; 22(5): 274-82, 2014 May.
Article
de En
| MEDLINE
| ID: mdl-24788443
ABSTRACT
Although once considered an invariably fatal injury, improvements in diagnosis and management have made atlanto-occipital dislocation (AOD) a survivable injury. MRI is the preferred imaging modality; occasionally, flexion/extension/distraction fluoroscopy may be required to determine craniovertebral stability. Early surgical stabilization is recommended for all children with AOD. Early occipitocervical fusion using screws in combination with a rod or plate, or sublaminar wires with a contoured rod, coupled with autograft bone, provide immediate stabilization and a high fusion rate. Halo immobilization and traction are contraindicated in the management of AOD in children because of the risk of displacement of the injured occipitocervical joint. Postoperative hydrocephalus is frequent and should be suspected when neurologic decline occurs after fixation. Nearly half of children who survive AOD will have residual neurologic deficits.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Articulation atlanto-occipitale
/
Arthrodèse vertébrale
/
Luxations
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limites:
Child
/
Child, preschool
/
Humans
/
Infant
Langue:
En
Journal:
J Am Acad Orthop Surg
Sujet du journal:
ORTOPEDIA
Année:
2014
Type de document:
Article