Traumatic posterior atlantooccipital dislocation with Jefferson and occipital condyle fractures: A case report

Medicine (Baltimore). 2019 Aug;98(31):e16668. doi: 10.1097/MD.0000000000016668.

Abstract

Rationale: To the best of our knowledge, this is the first report on a case of a traumatic posterior atlantooccipital dislocation (AOD) with 3-part Jefferson and occipital condyle fractures.

Patient concerns: We report the case of a 60-year-old male with posterior AOD with 3-part Jefferson fracture and fracture of right occipital condyle. This injury occurred as a result of rolling down from a mountain. The patient complained of severe neck pain showing bony tenderness and ecchymosis in the high cervical area but did not show any neurologic abnormalities.

Diagnoses: Reconstructed computed tomography scans clearly demonstrated a 3-part Jefferson fracture and fracture of right occipital condyle, and posteriorly displaced occiput with respect to the anterior arch of C1 and dens of C2.

Intervention: We planned to perform occipitocervical fusion; however, the patient refused treatment. He was transferred to another hospital and lost to follow-up.

Outcomes: Although extremely rare, patient who had posterior AOD with 3-part Jefferson and occipital condyle fractures can survive without neurological compromise, as was observed in our patient.

Lessons: Clinical suspicion with thorough radiographic and physical examinations are very important for diagnosing of the upper cervical spine injuries such as AOD with Jefferson and occipital condyle fractures.

Publication types

  • Case Reports

MeSH terms

  • Humans
  • Joint Dislocations / diagnosis*
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / surgery
  • Male
  • Middle Aged
  • Occipital Bone / diagnostic imaging
  • Occipital Bone / pathology*
  • Occipital Bone / surgery
  • Spinal Fractures / diagnosis*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery
  • Spinal Fusion / methods
  • Tomography, X-Ray Computed