The authors present and discuss the differential diagnosis for a 7-month-old infant who was seen in the ED after having been involved in a motor vehicle accident. The infant was subsequently found to have an odontoid fracture. Strict attention to the mechanism of injury is emphasized for appropriate evaluation of this patient's condition. An infant who becomes airborne in a car that is extensively damaged deserves an aggressive workup. In a child of this age, examination for subtle or even quite significant injury is difficult. Therefore, the focus should be on the potential for injury. This article addresses the rarity of this injury pattern and discusses factors involved in treatment of cervical spine injuries in pediatric patients. The development of the axis and radiography of the cervical spine in pediatric patients are reviewed also. Neurosurgical treatment options are presented. This case also reminds us to ensure parents understand the proper use of a car seat. (A)
Abstract