Atlanta1 Fracture in a Child through Congenital Anterior and Posterior Arch Defects

A five-year-old boy sustained a vertical compression injury to the occiput, initial findings were consistent with a cervical spine injury. Evaluation, including plain films, tomograms, and CT scanning, confirmed a C1 fracture through congenital anterior and posterior arch defects. Flexion and extension tomograms showed this rare lesion to be stable, and no surgical intervention was required. Because congenital anomalies of the cervical spine can be confused with traumatic lesions, thorough evaluation is warranted. Treatment should be based on signs of instability, if present.