decelleration injury leading to dislocation with hyperflexion
beaware of SOB, cranial nerve dysfunction & motor dysfunction
do not overdistract the patient
Powers ratio
Powers ratio
is determined by drawing a line from the basion (B) to the posterior arch of the atlas (C) & a second line from the opisthion (O) to the anterior arch of the atlas (A).The length of line BC is divided by the length of line Osteoarthritis
A ratio greater than 1.0 is diagnostic of anterior atlantooccipital translation, & a ratio less than 0.55 is diagnostic of posterior translation.
Treatment
In children who are younger the posterior elements are generally not well formed at C1, hence we fuse occiput –C3
In adolescent they use a triple wire technique one through the occiput, one sublaminar at the atlas & one through the spinous process of C2 & these are tied down over iliac crest bonegrafts
Post operative treatment includes halo immobilization
