{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T15:37:01Z","timestamp":1764603421627,"version":"3.44.0"},"reference-count":37,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,12,23]]},"abstract":"<jats:p>A 2-year-old girl fell off a bunk bed onto a parquet floor. She immediately reported neck pain and presented with muscle spasm and limited motion of the cervical spine (C-spine). Plain X-rays of the C-spine showed no osseous lesion. Owing to persisting pain and limited motion in the neck, MRI of the C-spine was obtained which revealed intact ligaments and cervical spinal cord, as well as soft tissue swelling in front of the anterior arch of the atlas. Subsequent CT of the C-spine confirmed a complete, undisplaced fracture of the anterior arch of the atlas (Gehweiler type I fracture). A Minerva cast was applied for 2\u2005months, followed by a soft cervical collar. Persistent neck pain and limited range of motion of the neck after a fall may be indicative of atlas fracture that should be ruled out by CT.<\/jats:p>","DOI":"10.1136\/bcr-2016-214472","type":"journal-article","created":{"date-parts":[[2017,1,10]],"date-time":"2017-01-10T10:24:57Z","timestamp":1484043897000},"page":"bcr2016214472","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Delayed diagnosis of fractured anterior arch of the atlas in a young child"],"prefix":"10.1136","volume":"2017","author":[{"given":"Sergio B","family":"Sesia","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, University Children's Hospital (UKBB), Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friederike","family":"Pr\u00fcfer","sequence":"additional","affiliation":[{"name":"Department of Paediatric Radiology, University Children's Hospital, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Walther","sequence":"additional","affiliation":[{"name":"Department of Emergency, University Children's Hospital, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Studer","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Spine Surgery, University Children's Hospital, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,1,10]]},"reference":[{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2001.25665"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.2","doi-asserted-by":"crossref","first-page":"705","DOI":"10.3171\/jns.1992.77.5.0705","article-title":"Pediatric spinal injury: review of 61 deaths","volume":"77","author":"Hamilton","year":"1992","journal-title":"J Neurosurg"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.3","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200201150-00021"},{"issue":"1","key":"2025082707093928000_2017.jan10_2.bcr2016214472.4","first-page":"102","article-title":"Severe posttraumatic craniocervical instability in the very young patient. Report of three cases","volume":"101","author":"Ghatan","year":"2004","journal-title":"J Neurosurg"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.5","doi-asserted-by":"publisher","DOI":"10.3171\/2011.6.PEDS11187"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.6","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2003.012310"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.7","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.115946"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.8","unstructured":"Gehweiler JA , Osborne RH , Becker RF . The radiology of vertebral trauma. Philadelphia: Saunders, 1983."},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.9","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000106487.89648.88"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.10","first-page":"1167","article-title":"Partial aplasia of the posterior arch of the atlas with an isolated posterior arch remnant: findings in three cases","volume":"21","author":"Sharma","year":"2000","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.11","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3171\/SPI-07\/10\/399","article-title":"The frequency and clinical significance of congenital defects of the posterior and anterior arch of the atlas","volume":"4","author":"Senoglu","year":"2007","journal-title":"J Neurosurg Spine"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.12","first-page":"385","article-title":"Atlas fractures","volume":"28","author":"Sch\u00e4ren","year":"1999","journal-title":"Orthop\u00e4de"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.13","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199030040-00017"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.14","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.2106\/00004623-197052050-00016","article-title":"Fractures of the atlas","volume":"52","author":"Sherk","year":"1970","journal-title":"J Bone Joint Surg Am"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.15","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000221802.83549.46"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.16","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/BPO.0000000000000167","article-title":"Spine trauma in very young children: a retrospective study of 206 patients presenting to a level 1 pediatric trauma center","volume":"34","author":"Knox","year":"2014","journal-title":"J Pediatr Orthop"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.17","doi-asserted-by":"publisher","DOI":"10.3171\/2008.10.PEDS08243"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.03.041"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.19","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1136\/bmj.324.7337.591","article-title":"Lesson of the week: immobilisation of the cervical spine in children","volume":"324","author":"Skellett","year":"2002","journal-title":"BMJ"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.20","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.47.8.781"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.21","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.1016\/j.injury.2013.08.004","article-title":"Isolated fracture of anterior arch of atlas in a child: case report and review of the literature","volume":"44","author":"Kazanci","year":"2013","journal-title":"Injury"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.22","first-page":"12","article-title":"Overview and comparison of NEXUS and Canadian c-spine rules","volume":"3","author":"Eyre","year":"2006","journal-title":"Am J Clin Med"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.23","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/S0733-8627(20)30218-2","article-title":"Imaging of the atlas (C1) and axis (C2)","volume":"9","author":"Ellis","year":"1991","journal-title":"Emerg Med Clin North Am"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.24","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/PEC.0000000000000126","article-title":"Fracture of the anterior arch of atlas after minor trauma of the immature spine postlaminectomy","volume":"30","author":"Baghdassarian","year":"2014","journal-title":"Pediatr Emer Care"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.25","first-page":"991","article-title":"Pediatric atlas fracture: a case of fracture through a synchondrosis and review of the literature","volume":"46","author":"Judd","year":"2000","journal-title":"Neurosurgery"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.26","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.2106\/00004623-197860080-00017","article-title":"Atlas fracture: demonstration using computerized tomography. A case report","volume":"60","author":"Keene","year":"1978","journal-title":"J Bone Joint Surg Am"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.27","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/pan.12903","article-title":"Outcomes following implementation of a paediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies","volume":"26","author":"Grunwell","year":"2016","journal-title":"Paediatr Anaesth"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.28","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800072713"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.29","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1227\/01.NEU.0000366108.02499.8F","article-title":"Atlas fractures","volume":"66","author":"Kakarla","year":"2010","journal-title":"Neurosurgery"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.30","doi-asserted-by":"crossref","first-page":"543","DOI":"10.2106\/00004623-197052030-00013","article-title":"Bursting atlantal fracture associated with rupture of the transverse ligament","volume":"52","author":"Spence","year":"1970","journal-title":"J Bone Joint Surg Am"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.31","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.6288"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.32","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1097\/00006123-200203001-00020","article-title":"Isolated fractures of the atlas in adults","volume":"50","author":"Hadley","year":"2002","journal-title":"Neurosurgery"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.33","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s10140-006-0565-x","article-title":"Anteroposterior spondyloschisis of the atlas. Two case reports and literature review","volume":"13","author":"Muthu","year":"2007","journal-title":"Emerg Radiol"},{"issue":"2","key":"2025082707093928000_2017.jan10_2.bcr2016214472.34","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1227\/NEU.0b013e318276ee2a","article-title":"Management of isolated fractures of the atlas in adults","volume":"72","author":"Ryken","year":"2013","journal-title":"Neurosurgery"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.35","first-page":"934135","article-title":"Fracture of the atlas through a synchondrosis of anterior arch","volume":"2013","author":"Turk","year":"2013","journal-title":"Case Rep Radiol"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.36","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1089\/neu.2009.1153","article-title":"Spinal cord injury in the pediatric population. A systematic review of the literature","volume":"28","author":"Parent","year":"2011","journal-title":"J Neurotrauma"},{"key":"2025082707093928000_2017.jan10_2.bcr2016214472.37","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0973-0508(10)80031-0","article-title":"Factors affecting long-term outcome in acute cervical cord injury","volume":"7","author":"Narasinga Rao","year":"2010","journal-title":"Indian J Neurotrauma"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-214472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:09:50Z","timestamp":1756303790000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-214472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,10]]},"references-count":37,"alternative-id":["10.1136\/bcr-2016-214472"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-214472","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,1,10]]}}}