مرکز منطقه ای اطلاع رساني علوم و فناوري - A diagnose not to miss: Rotatory Atlantoaxial subluxation in emergency service

Abstract :

Objective: The objective of this study is to take attention to atlantoaxial subluxations especially inpediatric population that may be misdiagnosed in the emergency services easily. When diagnosedearly in the emergency services, it may be corrected with ease and the treatment is more likely tobe conservative. Method: Seven patients with atlantoaxial rotatory subluxation (AARS), between ages of 5 and 13, who admitted to our emergency service between 1 July 2013 - 1 September 2014 were examined retrospectively. Results: All patients were treated conservatively with bed rest, muscle relaxants and rigid cervical collar. None of them needed surgery. Conclusions: Atlantoaxial rotatory subluxation (AARS) is one of the main types of cervical spine anomalies seen in pediatric patients and is a rare condition that is often misdiagnosed and therefore incorrectly managed especially in emergency services. The diagnosis requires a high index of suspicion. Many pediatric cervical spine injuries can be treated with external immobilization and AARS is almost always reducible. Pediatric population is prone to upper spine injuries due to ligamentous laxity and AARS should always be kept in mind especially in emergency services.