Transpharyngeal closed reduction displacement of the first cervical vertebra in children

BACKGROUND: Currently, the treatment of children with atlantoaxial rotational block has no standard protocol. The proposed conservative methods are difficult and require long-term hospitalization, whereas surgical is associated a risk complications.
 AIM: This study aimed to develop evaluate effectiveness transpharyngeal closed reduction method for first cervical vertebral displacement in children.
 MATERIALS AND METHODS: presents analysis results clinical cases 46 fixation types III subluxations by Fielding Hawkins CI method. average age patients was 4.5 2.6 years. time admission after disease onset varied from 1 30 days. technique consisted following elements: 1. A bracket installed traction behind skull along axis; 2. surgeon pulls axis, while using index finger other hand oropharynx fixes anterior arch atlas, creating fulcrum; 3. Rotational atlas eliminated movements simultaneous 4. anatomical position axis controlled an X-ray image intensifier.
 RESULTS: Only one case recurrent dislocation noted 4 efficiency primary 97.8%. Pain syndrome on visual analog scale reduced 62.3%. Neurological deficit recurrence not noted. bed-day 2.5 1.3 days.
 CONCLUSION: Transpharyngeal younger group effective early admitted patients, which determines prospects its wider application practice specialized hospitals.