Management of a 9-Month-Old Infant with Traumatic Atlanto-occipital Dislocation and Atlantoaxial Instability

Case: We report a 9-month-old girl who was involved in a motor vehicle collision and sustained atlanto-occipital dislocation (AOD), atlantoaxial instability, and a C2 synchondrosis fracture. Initial management with a halothoracic vest for damage control failed to maintain reduction, necessitating definitive posterior occipitocervical fusion. Conclusion: Traumatic AOD is a rare injury, most common in children following high-energy trauma. Early diagnosis and timely intervention are imperative for improved clinical outcomes. Even in young patients with small anatomy, with careful preoperative planning, occipitocervical fusion is effective and safe with successful postoperative outcomes.