Unilateral lag screw fixation of isolated non-union atlas lateral mass fracture: a new technical note

Abstract

We describe a novel and new technique of posterior unilateral lag screw fixation of non-union atlas lateral mass fracture. A 46-year-old man presented with cervical pain and tenderness after a vehicle turn over accident and he was diagnosed to have left atlas lateral mass fracture. He was initially treated by immobilization using Minerva orthosis. About 2 months later, he developed severe neck pain and limitation of motion and thus he was scheduled for operation due to non-union atlas lateral mass fracture. A 28 mm lag screw was inserted under anterior-posterior and lateral fluoroscopic views. The entrance point was at the dorsal aspect of left atlas posterior arc at its junction to the lateral mass, and by using the trajectory of 10 degrees medial and 22 degrees cephalad fracture reduction was achieved. Unilateral lag screw fixation of atlas fractures is an appropriate, safe and effective surgical technique for the management of unilateral atlas fractures.

Keywords:

• Atlas
• lateral mass fracture
• lag screw fixation
• posterior approach

Acknowledgements

The authors would like to thank Ms. Hosseini and Ms. Gholami from the Shiraz Neuroscience Research Center for their kind assistance.

Disclosure statement

There is no conflict of interest to be declared regarding the manuscript.

Additional information

Funding

This article has no source of funding.