PMC3971561_01
The patient could not move his head at all from its position facing to the right (a). A lacerated wound over the right inferior mandible (b).
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On initial consultation, the patient could not move his head at all from its position facing to the right (Figure 1(a)). A lacerated wound (Figure 1(b)), about 1 cm in length, was observed over the right inferior mandible.
Computed tomography revealed that the atlas was rotated to the right centering on the dens of the axis. (a) Axial view of atlas and (b) axial view of axis.
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Computed tomography (Figure 2) revealed that the atlas was rotated to the right centering on the dens of the axis.
The three-dimensional CT showed atlantoaxial rotatory fixation of Fielding classification type I. (a) Posterior view and (b) anterior view.
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Based on a three-dimensional CT (Figure 3), we diagnosed AARF of Fielding classification type I without a protruding eccentric jaw position.
CT after reduction of atlantoaxial rotatory fixation. (a) Axial view of atlas, (b) axial view of axis, and (c) anterior view of three-dimensional CT.
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MRI after reduction indicated no major soft tissue damages, and CT after reduction (Figure 4) showed that the dislocation had been reduced, so fixation with a Philadelphia collar was performed.