The Journal of Bone and Joint Surgery (American). 2009;91:2713-2718.
doi:10.2106/JBJS.H.01405
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Isolated Alar Ligament Disruption in Children and Adolescents as a Cause of Persistent Torticollis and Neck Pain After Injury

A Report of Three Cases

Michelle S. Caird, MD1, Robert N. Hensinger, MD1, Kelly L. Vander Have, MD1, Martin K. Gelbke, MD2 and Frances A. Farley, MD1

1 Pediatric Orthopaedics Service, Department of Orthopaedic Surgery, The University of Michigan, 1500 East Medical Center Drive, TC 2912, Ann Arbor, MI 48109. E-mail address for M.S. Caird: sugiyama@med.umich.edu
2 230 Michigan Avenue N.E., Grand Rapids, MI 49503

Investigation performed at the Department of Orthopaedic Surgery, The University of Michigan, Ann Arbor, Michigan

The first 150 words of the full text of this article appear below.


   Introduction
 
The alar ligaments are small paired spinal ligaments that attach from the occiput to the proximal portion of the odontoid process of the second cervical vertebra (C2). Injury to the upper cervical spine in children is infrequent, and isolated injury of the alar ligaments is even more uncommon, with only a report of two cases, in German, appearing in the literature1. Here we describe isolated alar ligament disruptions in three children. This injury caused persistent torticollis and neck pain in which neither fracture nor anterior or posterior listhesis was detected on radiographic studies. The injury did not lead to instability in the upper cervical spine in any of the patients.

Medical records and radiographs of three patients with isolated alar ligament disruption were reviewed. Data collected included age of the patient at the time of injury, mechanism of injury, presentation of the patient, method of treatment, time to healing, . . . [Full Text of this Article]


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