Concomitant alar and apical ligament avulsion in atlanto-axial rotatory fixation. Case report and review of the literature.

Published online: Apr 27 2004

Karray M, M'nif N, Mestiri M, Kooli M, Ezzaouia K, Zlitni M.

Department of Orthopaedic Surgery, Charles Nicolle Hospital, Tunis, Tunisia


The authors report a case of Fielding type II acute atlanto-axial rotatory fixation (AARF). The CT scan with coronal reconstruction showed an avulsion of the apical and right alar ligament. These findings are exceptionally reported in the literature, especially concerning the apical ligament which might be a stabiliser in flexion and extension of the occipitocervical joint.