Child's Nervous System ( IF 1.4 ) Pub Date : 2020-08-11 , DOI: 10.1007/s00381-020-04848-4 Pravin Salunke 1 , Parth Jani 1 , Sushanta K Sahoo 1 , Chandrashekhar Gendle 1
Background
Odontoid synchondral fractures in very young children with displacement/angulation are highly unstable and require surgical intervention. Soft and small bones with poor pull-out strengths make instrumentation and manipulation difficult.
Case report
We report an 18-month-old child with such a fracture where minimal traction made C1–2 dysjunction apparent with neurological worsening. The C1–2 facets were fixed with a short plate and facetal screws. The child had a good outcome.
Conclusion
Traction should be applied cautiously to avoid distraction injuries. Careful intraoperative manipulation should be planned to avoid any pull outs/fractures while realigning the spine and fixing it.
中文翻译:
在18个月大的儿童中发生C1-2功能不全的移位的齿状突突软骨合并骨折:挑战和解决方案。
背景
非常年轻的位移/成角度儿童的齿状突软骨骨折非常不稳定,需要手术干预。柔软而又细小的骨头,抗拉强度很差,使器械和操作变得困难。
案例报告
我们报道了一个有这种骨折的18个月大儿童,其最小的牵引力使得C1-2分离异常明显,神经系统恶化。C1–2小平面用短板和小螺钉固定。这个孩子有一个好的结果。
结论
小心使用牵引力,以免分散注意力。在重新调整脊柱并固定脊柱时,应计划仔细的术中操作,以避免任何拉出/断裂。