Traumatic anterior atlantoaxial subluxation occurring in a professional rugby athlete - Case report and review of literature related to atlantoaxial injuries in sports activities

Study Design. This is a case report of traumatic anterior atlantoaxial subluxation occurring in a professional rugby athlete with a literature review. Objective. To report a rare case of traumatic anterior atlantoaxial subluxation in a professional rugby athlete. Summary of Background Data. Atlantoaxial subluxation occurring in a professional athlete is very rare, and only two cases have been reported so far. Methods. A 26-year-old professional rugby player sustained traumatic anterior atlantoaxial subluxation. The pathomechanism of the injury was hyperflexion. No quadriplegia existed, but severe anterior subluxation was found on functional radiographs and kinematic magnetic resonance imaging. Results. Surgical fixation of C1 - C2 was carried out, and no impairment was seen in his daily living, although he did not return to professional rugby. Conclusions. Anterior atlantoaxial subluxation in sports activities is very rare. The mechanism of this injury is hyperflexion, and the rupture of the transverse ligament is essential. Good prognosis has been reported; however, a return to high-level sports activities is thought to be a contraindication.