Non-operative treatment in children and adolescents with atlantoaxial rotatory subluxation
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Dosyalar
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Atlantoaksiyel rotator subluksasyon (AARS) çocuk ve adolesanlarda baş-boyun hareketlerinde kısıtlılık ve tortikollisle kendini gösteren, genellikle tanıda güçlük yaşanan ve beraberinde potansiyel riskler barındıran bir durumdur. Bu çalışmada cerrahi dışı yöntemlerle tedavi edilen 12 AARS olgusunun retrospektif analizi sunulmaktadır. Hastalar ve yöntem: AARS nedeni ile cerrahi dışı yöntemlerle tedavi edilen, ortalama yaşı 11,5 olan 12 hasta travma ve üst solunum yolu enfeksiyonu öyküsü, ek yaralanmalar, radyolojik bulgular, semptomların süresi, mentooksipital traksiyonun miktarı ve süresi ile tedavinin klinik sonuçları açısından değerlendirildi. Bulgular: Olguların 8’inde travmatik AARS saptanırken, 4 olguda subluksasyonların ardında travmatik bir neden bulunamadı. Olguların 10’unda Fielding ve Hawkins’e göre tip I, 2’sinde ise tip II subluksasyonlar saptandı. Tüm olgular yatak başı mentooksipital traksiyonla tedavi edildi. Traksiyonda kullanılan ortalama ağırlık 1,8 kg iken, ortalama traksiyon süresi 3,75 kg olarak hesaplandı. Olgular traksiyonla elde edilen klinik düzelmenin ardından 3 hafta Philadelphia boyunlukla takip edildi. Altıncı ay kontrollerde hiçbir olguda baş-boyun hareketlerinde kısıtlılık ve ağrı saptanmadı. Sonuçlar: Atlantoaksiyel eklem, baş rotasyonunun çoğundan sorumlu olan karmaşık bir yapıdır. Çocuk ve adolesanlarda boyun ağrısı ve torticollis ayırıcı tanısında atlantoaksiyel eklem patolojileri ve AARS mutlaka düşünülmeli ve ekarte edilmelidir. Tanıda gecikme yaşanan olguların tedavisinde cerrahi dışı yöntemlerle başarı şansı düşüktür.
Objective: Atlantoaxial rotatory subluxation (AARS) is an uncommon lesion seen mainly in children and adolescents. A retrospective analysis of 12 patients with AARS treated non-operatively is presented in this study. Material and Methods: Twelve patients with AARS who were treated non-operatively were evaluated retrospectively in terms of recent trauma and respiratory tract infection history, accompanying injuries, radiological findings, duration of symptoms, amount and duration of traction and clinical results of the treatment. Results: Traumatic AARS was present in 8 patients. No evidence of trauma was found in 4 patients. Type I subluxations in 10 and type II subluxations in 2 patients were found according to the Fielding and Hawkins classification. All patients were treated using bed-side mentooccipital tractions. The mean duration of bed-side mentooccipital traction was 3,75 days and the mean amount of load was 1.8 kg. All patients were kept in Philadelphia collars for additional 3 weeks after the clinical recovery. No limitations and pain in head movements were present in any patient at the sixth month follow-up examinations. Conclusion: Paediatric patients with neck pain and torticollis should be investigated concerning trauma and recent respiratory tract infection history in order to avoid any delay in diagnosis of a possible AARS.
Objective: Atlantoaxial rotatory subluxation (AARS) is an uncommon lesion seen mainly in children and adolescents. A retrospective analysis of 12 patients with AARS treated non-operatively is presented in this study. Material and Methods: Twelve patients with AARS who were treated non-operatively were evaluated retrospectively in terms of recent trauma and respiratory tract infection history, accompanying injuries, radiological findings, duration of symptoms, amount and duration of traction and clinical results of the treatment. Results: Traumatic AARS was present in 8 patients. No evidence of trauma was found in 4 patients. Type I subluxations in 10 and type II subluxations in 2 patients were found according to the Fielding and Hawkins classification. All patients were treated using bed-side mentooccipital tractions. The mean duration of bed-side mentooccipital traction was 3,75 days and the mean amount of load was 1.8 kg. All patients were kept in Philadelphia collars for additional 3 weeks after the clinical recovery. No limitations and pain in head movements were present in any patient at the sixth month follow-up examinations. Conclusion: Paediatric patients with neck pain and torticollis should be investigated concerning trauma and recent respiratory tract infection history in order to avoid any delay in diagnosis of a possible AARS.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Balkan Medical Journal
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
29
Sayı
3
