{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:22Z","timestamp":1787755822547,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 6-year-old boy with Hereditary Sensory and Autonomic Neuropathy Type IV (HSAN IV) presented after repetitive self-inflicted head trauma with new-onset headache and neck discomfort. He had a history of self-injurious behavior and was neurologically intact on exam. Imaging revealed a displaced odontoid synchondrosis fracture with C1 to C2 subluxation. Halo immobilization failed due to pin-site complications and behavior. He was successfully managed with staged nonoperative treatment including Minerva casting and cervicothoracic lumbar orthosis bracing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case highlights the limitations of halo immobilization in patients with pain insensitivity and reports the longest documented follow-up of upper cervical spine injury in HSAN IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.25.00421","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T17:00:06Z","timestamp":1774112406000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Successful Nonoperative Management of a Displaced Pediatric Odontoid Fracture in Hereditary Sensory and Autonomic Neuropathy Type IV"],"prefix":"10.2106","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7237-2196","authenticated-orcid":false,"given":"Lee R.","family":"Benaroch","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0231-3594","authenticated-orcid":false,"given":"Shawn","family":"Thirukumar","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ahmadi Pirshahid","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Bartley","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9181-5307","authenticated-orcid":false,"given":"Timothy","family":"Carey","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8777-2983","authenticated-orcid":false,"given":"Patrick","family":"Thornley","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, 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