{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:29:01Z","timestamp":1777465741005,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Traumatic posterior atlantoaxial dislocation (PAAD) without fracture of the odontoid process is a rare injury. Closed reduction by skull traction under C\u2010arm fluoroscopic guidance and open reduction have been reported previously for the treatment of PAAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To report a rare case of PAAD without fracture treated by closed manual reduction and posterior fixation. To provide a new method\u2014atlantoaxial dynamic test\u2014for confirming the integrity of the transverse ligament after reduction and evaluate the ideal treatment strategy for traumatic PAAD without fracture of the odontoid process or rupture of the transverse ligament.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A 54\u2010year\u2010old woman was riding in the passenger seat when her vehicle was rear\u2010ended by a car. X\u2010ray and computed tomography (CT) scans were used to diagnose PAAD without a related fracture. Closed manual reduction under C\u2010arm fluoroscopy was performed after applying general anesthesia <jats:italic>via<\/jats:italic> sober intubation, and the integrity of the transverse ligament was confirmed by the atlantoaxial dynamic test with C\u2010arm fluoroscopy. Then, pedicle screw internal fixation <jats:italic>via<\/jats:italic> the posterior approach was applied to maintain atlantoaxial stability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The procedure was performed uneventfully, and the patient was able to move out of bed on the first day after surgery with Philadelphia cervical gear. During a 2\u2010year follow\u2010up period, imaging data demonstrated no instability of the atlantoaxial complex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Closed manual reduction under C\u2010arm fluoroscopy is an easy and effective method for PAAD. The integrity of the transverse ligament can be confirmed by C\u2010arm fluoroscopy through the atlantoaxial dynamic test after reduction. Pedicle screw internal fixation <jats:italic>via<\/jats:italic> the posterior approach can provide sufficient stability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13095","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T03:09:58Z","timestamp":1639624198000},"page":"451-455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Surgical Management for Posterior Atlantoaxial Dislocation without Fracture and Atlantoaxial Dynamic Test to Confirm the Integrity of the Transverse Ligament: A Case Report"],"prefix":"10.1111","volume":"14","author":[{"given":"Cheng","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3586-8403","authenticated-orcid":false,"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6294-6243","authenticated-orcid":false,"given":"Zeqing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunli","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Shengjing Hospital of China Medical University  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,15]]},"reference":[{"key":"e_1_2_4_2_1","first-page":"61","article-title":"Subluxations, dislocations and fracture\u2010dislocations of the atlanto\u2010axial joint","volume":"5","author":"Dangelmajer RC","year":"1962","journal-title":"Bull Hosp Spec Surg"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196446080-00019"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196951030-00016"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000365830.10052.87"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000366109.85796.42"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199503010-00002"},{"key":"e_1_2_4_8_1","first-page":"138","article-title":"Quantitative anatomic study of atlanto\u2010odontoid joint and design of an artificial atlanto\u2010odontoid joint for the orthopedic clinic","volume":"10","author":"Hu Y","year":"2007","journal-title":"Chin J Traumatol"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197456030-00023"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2007.07.022"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.121597"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197456060-00020"},{"key":"e_1_2_4_13_1","first-page":"73","article-title":"Posterior atlantoaxial dislocation without fracture. Case report","volume":"98","author":"Yoon DH","year":"2003","journal-title":"J Neurosurg"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-007-0439-7"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-1150-2"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200307000-00023"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-010-1228-7"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001872"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000334"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-002-0540-x"},{"key":"e_1_2_4_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5823-6"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.13095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T12:57:39Z","timestamp":1693141059000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,15]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1111\/os.13095"],"URL":"https:\/\/doi.org\/10.1111\/os.13095","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,15]]},"assertion":[{"value":"2021-01-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}