• Eur Spine J · Jul 2009

    Case Reports

    Rotatory atlanto-axial dislocation in an infant with osteogenesis imperfecta.

    • Joel Humphrey and James Wilson-Macdonald.
    • West Middlesex University Hospital NHS Trust, Twickenham Road, Isleworth, Middlesex, UK. drjoelhumphrey@aol.com
    • Eur Spine J. 2009 Jul 1;18 Suppl 2:168-71.

    AbstractThis is a case report of a 15-month-old patient with osteogenesis imperfecta (OI) who sustained atlanto-axial dislocation. Our objective is to report a unique case of traumatic atlanto-axial subluxation in a child with osteogenesis imperfecta associated with bilateral femoral fractures. The management is discussed. Atlanto-axial dislocation occurring with associated osteogenesis imperfecta is very rare. There have been no previous reported cases. A 15-month-old girl with osteogenesis imperfecta sustained a traumatic atlanto-axial dislocation. The child was followed-up through presentation, diagnosis, management and post-discharge. The initial diagnosis was confirmed with a CT scan. The patient was treated conservatively with a halo-traction for 4 weeks followed by a halo jacket for a further 4 weeks. Both appliances were fitted under general anaesthetic. An anatomical reduction was achieved. There was no neurological deficit at any stage. The child has had a successful outcome. She is asymptomatic with a full range of movement at the atlanto-axial joints at 9 months. In conclusion, this paper records our management of this rare problem.

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