Traumatic complex dislocation of the atlanto-axial joint with odontoid and C2 superior articular facet fracture.

Abstract

Case report and clinical discussion. We intend to report a unique case of a atlantoaxial dislocation with a odontoid and C2 superior articular facet fracture. Traumatic dislocation of the atlantoaxial joint in combination with a C2 fracture is a rare injury. Only 5 cases have been reported in the literature. We present a case of a 43-year-old man with a primary atlantoaxial complex dislocation associated with an odontoid and comminuted C2 superior articular facet fracture with complete recovery of an accompanying hemiplegia after reduction. The patient underwent gentle traction with a halo frame until a complete reduction was achieved within 3 days, after which a vest was installed. His neurologic status improved to a slight weakness of the right shoulder in abduction (Grade 4/5) after 4 months and his C2 fracture healed in an acceptable position. To our knowledge, this is the first case of a traumatic atlantoaxial rotatory dislocation with accompanying odontoid and C2 superior articular facet fracture.