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Occipitocervical Fusion for Severe Atlantoaxial Dislocation in an Underdeveloped Child with Chondrodysplasia Punctata

A Case Report

Tanaka, Yuki, MD1; Watanabe, Kei, MD, PhD1,a; Katsumi, Keiichi, MD, PhD1; Ohashi, Masayuki, MD, PhD1; Nagasaki, Keisuke, MD, PhD1; Hirano, Toru, MD, PhD1

doi: 10.2106/JBJS.CC.16.00121
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Case: We present a case of brachytelephalangic chondrodysplasia punctata with a severe atlantoaxial dislocation in an underdeveloped child. The patient underwent halo jacket application using 10 halo pins with <1 lb/in2 of torque, followed by posterior occipitocervical fusion with onlay rib and iliac autografts. After bone grafts and replacement of the halo ring multiple times, successful osseous fusion had been achieved by the 2-year follow-up.

Conclusion: Although simple bone-grafting with a halo jacket is useful in underdeveloped patients with skeletal dysplasia, the complications related to halo fixation, including cranial bone perforation, and the patient’s neurological status must be carefully monitored.

1Departments of Orthopedic Surgery (Y.T., K.W., K.K., M.O., and T.H.) and Pediatrics (K.N.), Niigata University Medical and Dental General Hospital, Niigata City, Niigata, Japan

aE-mail address for K. Watanabe: keiwatanabe_39jp@live.jp

Copyright © 2017 by The Journal of Bone and Joint Surgery, Incorporated
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