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Traumatic atlanto-axial rotary subluxation (AARS) in a 6-year-old child during recreational jūdō practice: a case report and mini-review of serious neck injuries in jūdō

Carl De Crée (UGent)
(2019) ARCHIVES OF SPORTS MEDICINE. 3(1). p.134-148
Author
Organization
Abstract
Introduction: Traumatic atlanto-axial rotational subluxations (AARS) represent a serious condition that is associated with neurological complications, and should be considered among jūdō sports injuries involving the neck. Case presentation: A 6-year-old Caucasian girl with approximately 1 year of recreational jūdō experience presented with neck and shoulder pain while holding her head in a “Cock-robin” sideways tilted position. During a children’s jūdō class while seated on “all fours” she had been subjected to an improperly executed turnover performed by a boy of similar age, body mass and experience. Because of increasing torticollis symptoms after class she was taken by her parents to a local hospital’s emergency department where X-rays showed a mid-clavicular fracture. It was not until 7 weeks post-accident that a CT scan was ordered and a type-III traumatic acute AARS causing her clinical symptoms was recognized. Differential diagnosis: Congenital cervical spine anomalies, Grisel’s syndrome, Juvenile rheumatoid arthritis, Odontoid fracture without atlanto-axial dislocation. Treatment: A halo crown traction brace connected to a cervical traction pulley with gradual increased weight (+0.5 kg every half day to a maximum of 6.5 kg) was used for reduction over a 17-day period, followed by 6 weeks of ambulant immobilization with a halo vest, and 8 weeks of wearing a stiff neck brace. The girl fully recovered but was advised not to return to practicing contact sports. Uniqueness of the study: AARS has not previously been described in association with jūdō practice in children. Conclusion: Traumatic AARS should be considered as a potential diagnosis in jūdōka, especially those of very young age and of female gender, when presenting with torticollis following mechanical impact or severe pressure on the head if blocked in a tilted position. Prompt diagnosis is crucial, preferably by open-mouth X-rays and CT scan, to ensure proper management and prevent neurological complications.
Keywords
Athletic injuries, Atlanto-axial, Cervical vertebrae, Children, Judo, Martial arts, Neck injuries, Sports injuries, Sprains and strains

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Citation

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MLA
De Crée, Carl. “Traumatic Atlanto-axial Rotary Subluxation (AARS) in a 6-year-old Child During Recreational Jūdō Practice: a Case Report and Mini-review of Serious Neck Injuries in Jūdō.” ARCHIVES OF SPORTS MEDICINE 3.1 (2019): 134–148. Print.
APA
De Crée, C. (2019). Traumatic atlanto-axial rotary subluxation (AARS) in a 6-year-old child during recreational jūdō practice: a case report and mini-review of serious neck injuries in jūdō. ARCHIVES OF SPORTS MEDICINE, 3(1), 134–148.
Chicago author-date
De Crée, Carl. 2019. “Traumatic Atlanto-axial Rotary Subluxation (AARS) in a 6-year-old Child During Recreational Jūdō Practice: a Case Report and Mini-review of Serious Neck Injuries in Jūdō.” Archives of Sports Medicine 3 (1): 134–148.
Chicago author-date (all authors)
De Crée, Carl. 2019. “Traumatic Atlanto-axial Rotary Subluxation (AARS) in a 6-year-old Child During Recreational Jūdō Practice: a Case Report and Mini-review of Serious Neck Injuries in Jūdō.” Archives of Sports Medicine 3 (1): 134–148.
Vancouver
1.
De Crée C. Traumatic atlanto-axial rotary subluxation (AARS) in a 6-year-old child during recreational jūdō practice: a case report and mini-review of serious neck injuries in jūdō. ARCHIVES OF SPORTS MEDICINE. Carson City, NV; 2019;3(1):134–48.
IEEE
[1]
C. De Crée, “Traumatic atlanto-axial rotary subluxation (AARS) in a 6-year-old child during recreational jūdō practice: a case report and mini-review of serious neck injuries in jūdō,” ARCHIVES OF SPORTS MEDICINE, vol. 3, no. 1, pp. 134–148, 2019.
@article{8610749,
  abstract     = {Introduction: Traumatic atlanto-axial rotational subluxations (AARS) represent a serious condition that is associated with neurological complications, and should be considered among jūdō sports injuries involving the neck.
Case presentation: A 6-year-old Caucasian girl with approximately 1 year of recreational jūdō experience presented with neck and shoulder pain while holding her head in a “Cock-robin” sideways tilted position. During a children’s jūdō class while seated on “all fours” she had been subjected to an improperly executed turnover performed by a boy of similar age, body mass and experience. Because of increasing torticollis symptoms after class she was taken by her parents to a local hospital’s emergency department where X-rays showed a mid-clavicular fracture. It was not until 7 weeks post-accident that a CT scan was ordered and a type-III traumatic acute AARS causing her clinical symptoms was recognized. 
Differential diagnosis: Congenital cervical spine anomalies, Grisel’s syndrome, Juvenile rheumatoid arthritis, Odontoid fracture without atlanto-axial dislocation.
Treatment: A halo crown traction brace connected to a cervical traction pulley with gradual increased weight (+0.5 kg every half day to a maximum of 6.5 kg) was used for reduction over a 17-day period, followed by 6 weeks of ambulant immobilization with a halo vest, and 8 weeks of wearing a stiff neck brace. The girl fully recovered but was advised not to return to practicing contact sports.
Uniqueness of the study: AARS has not previously been described in association with jūdō practice in children.
Conclusion: Traumatic AARS should be considered as a potential diagnosis in jūdōka, especially those of very young age and of female gender, when presenting with torticollis following mechanical impact or severe pressure on the head if blocked in a tilted position. Prompt diagnosis is crucial, preferably by open-mouth X-rays and CT scan, to ensure proper management and prevent neurological complications.},
  articleno    = {ASPM-3-020},
  author       = {De Crée, Carl},
  issn         = {2578-6334},
  journal      = {ARCHIVES OF SPORTS MEDICINE},
  keywords     = {Athletic injuries,Atlanto-axial,Cervical vertebrae,Children,Judo,Martial arts,Neck injuries,Sports injuries,Sprains and strains},
  language     = {eng},
  number       = {1},
  pages        = {ASPM-3-020:134--ASPM-3-020:148},
  title        = {Traumatic atlanto-axial rotary subluxation (AARS) in a 6-year-old child during recreational jūdō practice: a case report and mini-review of serious neck injuries in jūdō},
  url          = {http://www.scholarlypages.org/Articles/sports-medicine/aspm-3-020.php?jid=sports-medicine},
  volume       = {3},
  year         = {2019},
}