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The JBJS Quiz of the Month is a collection of 10 relevant questions from each orthopaedic subspecialty. The questions are drawn from JBJS Clinical Classroom, which houses over 4,500 questions and 3,100 learning resources. Take the Quiz to see how you score against your peers!

NOTE: This quiz does not earn users CME credits. The questions must be answered within Clinical Classroom to earn CME credits.

A 3-year-old boy is struck by a car moving at high speed and presents to the emergency department with neck pain. If there is suspicion that he has sustained an atlanto-occipital dislocation, which of the following methods is preferred to immobilize his neck?
    • Apply the smallest adult-sized C-spine collar available
      • The preferred immobilization is sandbags/blocks around the head to immobilize the neck. An adult C-spine collar would likely distract the neck, worsening a presumed atlanto-occipital dislocation.
    • Apply gentle manual traction along the axis of the C-spine
      • The preferred immobilization is sandbags/blocks around the head to immobilize the neck. Applying in-line traction would distract the neck, worsening a presumed atlanto-occipital dislocation.
    • Place the child on an adult spine board
      • The preferred immobilization is sandbags/blocks around the head to immobilize the neck. An adult spine board will often cause neck flexion since the child’s head is relatively larger compared with the child’s body.
    • Apply sandbags/blocks to sides of head and tape them in place
      • The preferred immobilization is sandbags/blocks around the head to immobilize the neck, with a cutout in the transport board to prevent excessive neck flexion for a child.

     

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