J Korean Orthop Assoc.  2011 Dec;46(6):523-527.

Traumatic Atlantoaxial Unifacetal Joint Dislocation Associated with Fractures of Ipsilateral C2 Body and Contralateral Pars

• Cho CH
• Kim TK
• Min WK
• Park BC

Abstract

The traumatic C1-C2 unifacetal joint dislocation associated with oblique fractures of the C2 body and arch is a rare injury that can be effectively treated with gentle closed reduction under fluoroscopic guidance followed by halo vest immobilization. To our knowledge, however, there are only a few reported cases of this injury. Recognition of associated conditions including vertebral artery compromise, concomitant cervical spine fractures, and life-threatening injuries is paramount to the successful treatment of these patients. A 29-year-old patient, who presented a unifacetal dislocation at C1-C2 with associated oblique fractures of the C2 body and arch, is reported. Closed reduction with Gardner-Wells tong and halo vest application was performed. After 3 months of application of halo vest, the fractures of C2 body and arch had the complete union and the C1-2 dislocation had the good reduction. He had no pain and discomfort in his neck for about 2 years after halo vest removal.

Keyword

atlantoaxial fracture; unifacetal dislocation; halovest

MeSH Terms

Adult
Dislocations
Humans
Immobilization
Joints
Neck
Spine
Vertebral Artery

Figure

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  Figure 1 The open-mouth odontoid radiograph revealed slight rotation of C1 lateral mass.

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  Figure 2 The radiograph of the lateral cervical spine showed a facture of C2 pars interarticularis. But there was no translation or angulation of C1-C2 and C2-C3.

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  Figure 3 (A) The coronal view of computed tomography (CT) show the oblique body fracture of axis. (B) The three-dimensional CT scan demonstrated an atlantoaxial unifacetal dislocation and pars interarticulairs fracture of axis.

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  Figure 4 The plain lateral radiograph and the open-mouth odontoid radiograph showed the complete union of C2 fractures (body and pars interarticularis).

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