AtlantoAxial Rotatory Fixation: Part 3—A Prospective Study of the Clinical Manifestation, Diagnosis, Management, and Outcome of Children with AlantoAxial Rotatory Fixation

Children with painful torticollis should be subjected to the three-position computed tomographic diagnostic protocol, not only to secure the diagnosis of AARF but also to grade the severity of the condition by virtue of the dynamic motion curve. Closed reduction with traction should be instituted immediately to avoid the serious consequences of chronic AARF. Proper typing and reckoning of the pretreatment delay are requisites for selecting treatment modalities. Recurrent dislocation and incomplete reduction should be treated with posterior C1C2 fusion in the best achievable alignment. Open reduction and halo immobilization to avoid permanent fixation can be tried with select cases.