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C1 fractures are usually stable unless there is a ligamental rupture. As in this case your child did not require surgery. But my usual practise is to immobilise the spine with philadelphia collar and not soft collar. Now that we have crossed 5 months, I doubt that anymore fusion might occur at the anterior arch. But still I feel to immobilise with Philadelphia collar for 2 more months and calcium supplements need to be given.

You can check with your specialist and get dynamic X ray's of CV junction, that is, flexion and extension of the cervical spine to look for AAD(atlanto axial dislocation). If there is AAD(less likely in this case) then your child might need a surgery.


Regards

Hello again,

 She might not require any physical therapy as such.
  
 
As far as contact sports are concerned, better to avoid. I fear that even platform diving might have to be avoided. 
   
Regarding the doubt whether this fracture could be congenital; I could comment if have the same corresponding image taken immediately after the injury for comparison. 
   
 
Hope this helps, would be glad to answer any further queries.
  

Hello.


After seeing the image I feel that it may not be congenital but more likely of traumatic origin. As the immobilisation may not have been perfect, there is non union and also the fracture fragments have displaced further especially during the growing age(12-18yrs). I feel that the present fracture might not unite but the good thing is, as far as the ligaments are intact it should not pose any problem for her in her routine daily activities.
 
  
 
Thank you.