Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis

Atlanto-axial rotary subluxation (AARS) is rare but recognized as a significant cervical spine injury following a fall or physical impact on the head or neck in children aged 5–15 years. Trampoline use has been increasing among children, as have the trampoline-related injuries (TRI). We present a ca...

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Main Authors: Vijayanth Kanagaraju, Sri Deepa Kolathupalayam Srinivasan, Sherief Elsayed, Ravi Kumar Ponnappan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of Craniovertebral Junction and Spine
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Online Access:https://journals.lww.com/10.4103/jcvjs.jcvjs_154_24
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author Vijayanth Kanagaraju
Sri Deepa Kolathupalayam Srinivasan
Sherief Elsayed
Ravi Kumar Ponnappan
author_facet Vijayanth Kanagaraju
Sri Deepa Kolathupalayam Srinivasan
Sherief Elsayed
Ravi Kumar Ponnappan
author_sort Vijayanth Kanagaraju
collection DOAJ
description Atlanto-axial rotary subluxation (AARS) is rare but recognized as a significant cervical spine injury following a fall or physical impact on the head or neck in children aged 5–15 years. Trampoline use has been increasing among children, as have the trampoline-related injuries (TRI). We present a case series of AARS following trampoline injuries, highlighting clinical presentation, diagnosis, and management, especially in an emergency setting. We report four children with an average age of 8.5 years (range 6–12 years) presented to our hospital emergency service with neck pain and torticollis following a TRI. The diagnosis was confirmed through X-ray and computed tomography imaging, revealing Fielding and Hawkins type 1 AARS. Conservative treatment with analgesics, muscle relaxants, and a cervical collar led to recovery in three cases, while one required halter cervical traction for persistent deformity. All patients recovered completely, with no long-term complications. AARS in children is largely a type 1 injury with a favorable prognosis. Early recognition and management are crucial in preventing complications. The increasing incidence of neck injuries caused by trampoline use in children necessitates strict safety regulations regarding its use.
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publisher Wolters Kluwer Medknow Publications
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series Journal of Craniovertebral Junction and Spine
spelling doaj-art-372e2e582520461fba4b52b71bc5a2b92025-02-06T06:11:06ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852024-12-0115451551810.4103/jcvjs.jcvjs_154_24Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosisVijayanth KanagarajuSri Deepa Kolathupalayam SrinivasanSherief ElsayedRavi Kumar PonnappanAtlanto-axial rotary subluxation (AARS) is rare but recognized as a significant cervical spine injury following a fall or physical impact on the head or neck in children aged 5–15 years. Trampoline use has been increasing among children, as have the trampoline-related injuries (TRI). We present a case series of AARS following trampoline injuries, highlighting clinical presentation, diagnosis, and management, especially in an emergency setting. We report four children with an average age of 8.5 years (range 6–12 years) presented to our hospital emergency service with neck pain and torticollis following a TRI. The diagnosis was confirmed through X-ray and computed tomography imaging, revealing Fielding and Hawkins type 1 AARS. Conservative treatment with analgesics, muscle relaxants, and a cervical collar led to recovery in three cases, while one required halter cervical traction for persistent deformity. All patients recovered completely, with no long-term complications. AARS in children is largely a type 1 injury with a favorable prognosis. Early recognition and management are crucial in preventing complications. The increasing incidence of neck injuries caused by trampoline use in children necessitates strict safety regulations regarding its use.https://journals.lww.com/10.4103/jcvjs.jcvjs_154_24arthrodesisatlanto-axial rotary subluxationdislocationsomersaultstorticollistrampoline
spellingShingle Vijayanth Kanagaraju
Sri Deepa Kolathupalayam Srinivasan
Sherief Elsayed
Ravi Kumar Ponnappan
Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis
Journal of Craniovertebral Junction and Spine
arthrodesis
atlanto-axial rotary subluxation
dislocation
somersaults
torticollis
trampoline
title Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis
title_full Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis
title_fullStr Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis
title_full_unstemmed Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis
title_short Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis
title_sort atlantoaxial rotary subluxation in children after trampoline injury a critical but overlooked diagnosis
topic arthrodesis
atlanto-axial rotary subluxation
dislocation
somersaults
torticollis
trampoline
url https://journals.lww.com/10.4103/jcvjs.jcvjs_154_24
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AT srideepakolathupalayamsrinivasan atlantoaxialrotarysubluxationinchildrenaftertrampolineinjuryacriticalbutoverlookeddiagnosis
AT sheriefelsayed atlantoaxialrotarysubluxationinchildrenaftertrampolineinjuryacriticalbutoverlookeddiagnosis
AT ravikumarponnappan atlantoaxialrotarysubluxationinchildrenaftertrampolineinjuryacriticalbutoverlookeddiagnosis