THE LATERAL ATLANTOAXIAL JOINTS AND THEIR SYNOVIAL FOLDS - AN IN-VITRO STUDY OF SOFT-TISSUE INJURIES AND FRACTURES

Thirty victims of blunt cervical trauma, who did not survive (acute de ath group), were studied at autopsy as were 11 patients who survived t rauma for more than 1 month and ten controls without any known cervica l trauma. All specimens were sagitally sectioned in 2-mm slices and ca refully examined for injuries to the lateral parts of the atlanto-axia l joints. In the acute death group, five cases showed a rupture of the joint capsule, three of these with a massive hemarthrosis. In 17 case s there was bruising around the second cervical spinal nerve. Bruising of the intra-articular synovial fold was present in 15 cases, the pos terior synovial fold being most commonly affected. There were five int ra-articular fractures of the lateral masses, in three cases combined with a dens fracture. In two cases a bone fragment from the fracture c ompressed and obliterated the lumen of the vertebral artery. The findi ngs are discussed in relation to pain after cervical trauma.