Neurologic re-examination was completely normal, and no signs for Horner or Wallenberg's syndrome were present. There was no palpable tenderness and range of movement deficit in axis, resisted cervical flexion, extension, lateral flexion, and rotations in both directions, were painless upon physical examination in the sports medicine clinic. He was then free to leave the collar and was referred to the sports medicine outpatient clinic for further recommendations and exercise prescription. A second CT was performed in which callus formation was seen (Figure 3). Six weeks after the injury, he had no symptoms and physical examination was normal. The patient was advised to use a hard-collar for 6 weeks. A lateral radiograph was performed and probable C1 stable fracture (Figure 1) was confirmed with computed tomography (CT), which revealed the final diagnosis of "bilateral posterior arc fracture of the atlas" (Figure 2). There were no sensory or motor deficits on neurologic examination. ![]() Upon physical examination, he had tenderness on the cervical spine and pain on both active and passive neck extensions. The athlete then presented to the orthopedics department with symptoms of persistent dizziness and neck pain. running, stationary bicycle) but the dizziness did not resolve. He continued aerobic training for a week (i.e. Dizziness and cervical neck pain occurred immediately afterwards however, alleviation of these symptoms made him delay admittance to a clinic. He described a spring feeling on his spine followed by a sudden pain and loss of voluntary bodily control, which led him to fell on the ground. He was performing a backwards cartwheel movement and fell on his head on the mat before completing the movement. Here, we represent a case of atlas fracture in an amateur wrestler, the diagnosis, treatment, and return to sports process.Ī male amateur wrestler aged 25-year had a pain due to cervical neck injury during warm-up and could not continue training. The injury occurs when an athlete is grabbed and then thrown to the ground on their head by their opponent. ![]() The rate of catastrophic injuries is 0.01% in high school and collegiate athletes, which most commonly occurs during games when athletes are defending takedown movements. Wrestling, American football, gymnastics and ice hockey are type of sports known with such results. Due to its close proximity to the brainstem, C1 fractures may cause catastrophic results such as chronic disability or death. Shallow-water diving, falling or vehicle accidents are other common mechanisms of injury. Forces with sudden head or neck rotational moments may also cause fracture of atlas. Atlas (C1) fracture, seen in 2-13% of all spinal trauma cases and 2% of all spinal fractures, occur commonly with axial loading. Although they can be seen in many other sports, American football, rugby, surfing and ice hockey have a greater incidence. Wrestling injuries, Axial compression, Atlas fracture, Posterior arcĬervical neck injuries comprise of 0.8-14.9% of sports injuries and are commonly seen in wrestling. The patient was allowed to perform contact sports 12 weeks after the incident. After removal of the collar, cervical strengthening exercises were started, which gradually increased in the rehabilitation program. He was then treated with a hard collar for 6 weeks. X-ray and computed tomography of the patient revealed a stable fracture of C1 vertebra. He was admitted to the outpatient orthopedics clinic with persistent neck pain and dizziness after 7 days. ![]() A male amateur wrestler aged 25 years, who was otherwise healthy fell on his head while doing a cartwheel and could not continue training. ![]() Atlas bone fractures are rare although may result with catastrophic consequences. We present a case of a bilateral atlas posterior arc fracture that occurred during wrestling training. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Corresponding author: Sergen Devran, Sports Medicine Department, Istanbul University, Istanbul Faculty of Medicine, Turkey, E-mail: Int J Sports Exerc Med, IJSEM-3-055, (Volume 3, Issue 2), Case Report ISSN: 2469-5718 Received: Janu| Accepted: Ma| Published: March 20, 2017Ĭitation: Devran S, Akgul T, Gozubuyuk OB (2017) A Non-Displaced C1 Fracture in Amateur Wrestling: A Case Report.
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