Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation
Atlanto-axial rotatory fixation (AORF) develops on the background of acute torticollis. Widely adopted terms such as C1 subluxation or atlantooccipital rotational subluxation do not reflect the core of this pathology and carry negative weight in the diagnostics and treatment of AORF. Retrospective a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Russian |
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Vreden Russian Research Institute of Traumatology and Orthopedics
2016-06-01
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| Series: | Travmatologiâ i Ortopediâ Rossii |
| Subjects: | |
| Online Access: | https://journal.rniito.org/jour/article/view/11 |
| _version_ | 1819127894022029312 |
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| author | A. V. Gubin A. V. Burtsev S. O. Ryabykh D. M. Savin P. V. Ochirova A. A. Korkin |
| author_facet | A. V. Gubin A. V. Burtsev S. O. Ryabykh D. M. Savin P. V. Ochirova A. A. Korkin |
| author_sort | A. V. Gubin |
| collection | DOAJ |
| description | Atlanto-axial rotatory fixation (AORF) develops on the background of acute torticollis. Widely adopted terms such as C1 subluxation or atlantooccipital rotational subluxation do not reflect the core of this pathology and carry negative weight in the diagnostics and treatment of AORF. Retrospective analysis of the diagnostics and treatment outcome of 5 children with confirmed AORF diagnosis and literature review were performed. Clinical method, radiography and functional computer tomography were used to verify the diagnosis. De-rotational halo-traction and open correction with screw fixation were applied for treatment. Head position was managed to be improved in all patients. In one case the reduction was performed using correction in suboccipital segments and in other 4 cases the correction and fixation by Harms and de-rotational halo-traction allowed to correct torticollis. The pain syndrome had been arrested completely. Disease outcome resulted in formation of C1-C2 fibrous or bone fusion regardless the method of treatment. The patients with neglected AORF represent a great challenge for diagnostics and treatment. When conservative treatment fails it is necessary to involve de-rotational halo-traction with possible application of open reduction and posterior fusion. The purpose of treatment is to eliminate torticollis and pain using creation of proper C1-C2 alignment. The motions in atlantooccipital joint do not restore due to formation of the fibrous or bone fusion. |
| first_indexed | 2024-12-22T08:19:10Z |
| format | Article |
| id | doaj.art-d6cb6957bb964bcba8e25fc21d5f4ea8 |
| institution | Directory Open Access Journal |
| issn | 2311-2905 2542-0933 |
| language | Russian |
| last_indexed | 2024-12-22T08:19:10Z |
| publishDate | 2016-06-01 |
| publisher | Vreden Russian Research Institute of Traumatology and Orthopedics |
| record_format | Article |
| series | Travmatologiâ i Ortopediâ Rossii |
| spelling | doaj.art-d6cb6957bb964bcba8e25fc21d5f4ea82022-12-21T18:32:48ZrusVreden Russian Research Institute of Traumatology and OrthopedicsTravmatologiâ i Ortopediâ Rossii2311-29052542-09332016-06-0104879410.21823/2311-2905-2015-0-4-87-9410Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixationA. V. Gubin0A. V. Burtsev1S. O. Ryabykh2D. M. Savin3P. V. Ochirova4A. A. Korkin5Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»Ilizarov Russian Scientific Center «Restorative Traumatology and Orthopedics»Atlanto-axial rotatory fixation (AORF) develops on the background of acute torticollis. Widely adopted terms such as C1 subluxation or atlantooccipital rotational subluxation do not reflect the core of this pathology and carry negative weight in the diagnostics and treatment of AORF. Retrospective analysis of the diagnostics and treatment outcome of 5 children with confirmed AORF diagnosis and literature review were performed. Clinical method, radiography and functional computer tomography were used to verify the diagnosis. De-rotational halo-traction and open correction with screw fixation were applied for treatment. Head position was managed to be improved in all patients. In one case the reduction was performed using correction in suboccipital segments and in other 4 cases the correction and fixation by Harms and de-rotational halo-traction allowed to correct torticollis. The pain syndrome had been arrested completely. Disease outcome resulted in formation of C1-C2 fibrous or bone fusion regardless the method of treatment. The patients with neglected AORF represent a great challenge for diagnostics and treatment. When conservative treatment fails it is necessary to involve de-rotational halo-traction with possible application of open reduction and posterior fusion. The purpose of treatment is to eliminate torticollis and pain using creation of proper C1-C2 alignment. The motions in atlantooccipital joint do not restore due to formation of the fibrous or bone fusion.https://journal.rniito.org/jour/article/view/11atlanto-axial rotatory fixationc1 subluxationacute torticollisfixation by harmshalo-traction |
| spellingShingle | A. V. Gubin A. V. Burtsev S. O. Ryabykh D. M. Savin P. V. Ochirova A. A. Korkin Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation Travmatologiâ i Ortopediâ Rossii atlanto-axial rotatory fixation c1 subluxation acute torticollis fixation by harms halo-traction |
| title | Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation |
| title_full | Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation |
| title_fullStr | Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation |
| title_full_unstemmed | Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation |
| title_short | Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation |
| title_sort | surgical treatment of children with non traumatic old atlanto axial rotatory fixation |
| topic | atlanto-axial rotatory fixation c1 subluxation acute torticollis fixation by harms halo-traction |
| url | https://journal.rniito.org/jour/article/view/11 |
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