Traumatic occipitocervical and atlantoaxial dislocation with clivus fracture in a child. Case report
Bibliographic record
Abstract
Craniovertebral junction lesions in the paediatric population are associated with a low survival rate, which has declined in recent years. Neurological disability is a major concern due to the high economical cost it represents. Paediatric patients are more susceptible to this lesion because of hyperextension capacity, flat articulation, and increased ligamentous laxity. Survival after these kinds of injuries has been more often reported in adults, but are limited in the paediatric population. A case of an 8-year-old male is reported with occipitocervical and atlantoaxial dislocation associated with clivus fracture, brain oedema, and post-traumatic subarachnoid haemorrhage. A halo vest system was placed with no traction. One month after the trauma the patient was surgically treated with C1 and C2 trans-articular screws, occipitocervical fixation with plate and screws, and C1–C2 fixation with tricortical bone graft and wires without complication. He has now returned to school and is self-sufficient. With better pre-hospital medical care and with improved surgical techniques the mortality rate has declined in this kind of lesion. Las lesiones traumáticas del complejo occipitoatloaxoideo en población pediátrica están asociadas con menor sobrevida, lo que en años recientes ha disminuido. La secuela neurológica que resulta de estas lesiones es un factor importante por el gran costo económico y emocional que representan. Los pacientes pediátricos son más susceptibles a este tipo de lesiones por la capacidad de hiperextensión, articulaciones planas y laxitud ligamentaria. La sobrevida con este tipo de lesiones se ha reportado mayormente en adultos y muy limitada en la población pediátrica. Presentamos el caso de un niño de 8 años de edad con luxación occipitocervical y atlantoaxial asociada con fractura del clivus, edema cerebral y hemorragia subaracnoidea; se aplicó un halo con chaleco sin tracción. Un mes posterior al traumatismo el paciente fue intervenido quirúrgicamente con tornillos transarticulares de C1–C2, fijación occipitocervical con una placa y tornillos, y fijación de C1–C2 con injerto tricortical óseo y alambres, sin ninguna complicación. Actualmente, el paciente acude a la escuela y es autosuficiente. Debido a la optimización de la atención prehospitalaria y la fusión de técnicas quirúrgicas, se ha logrado disminuir la mortalidad en este tipo de lesiones.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".