Pravin Salunke1, Parth Jani1, Sushanta K Sahoo2, Chandrashekhar Gendle1. 1. Neurosurgery, PGIMER, Chandigarh, Sector 12, Chandigarh, 1600l2, India. 2. Neurosurgery, PGIMER, Chandigarh, Sector 12, Chandigarh, 1600l2, India. drsushantsahoo@gmail.com.
Abstract
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.
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.