Traumatic Complex Dislocation of the Atlanto-Axial Joint With Odontoid and C2 Superior Articular Facet Fracture

In Brief Study Design. Case report and clinical discussion. Objective. We intend to report a unique case of a atlantoaxial dislocation with a odontoid and C2 superior articular facet fracture. Summary of Background Data. 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. Methods. 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. Results. 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. Conclusion. To our knowledge, this is the first case of a traumatic atlantoaxial rotatory dislocation with accompanying odontoid and C2 superior articular facet fracture. Traumatic atlantoaxial rotatory dislocation is infrequent. An accompanying odontoid and superior articular facet fracture has never been described before. We describe such a dislocation with hemiplegia that completely improved after reduction with halo traction.