The Journal of Bone and Joint Surgery, Vol 71, Issue 5 664-668, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
The management of rotatory atlanto-axial subluxation in children
WA Phillips and RN Hensinger
Section of Orthopaedic Surgery, University Hospital, University of Michigan, Ann Arbor 48109-0328.
Twenty-three children who were treated for rotatory atlanto-axial
subluxation between 1975 and 1986 were retrospectively studied. The success
of closed reduction with traction and the length of hospitalization were
related to the duration of symptoms before admission. In sixteen of the
children, who were seen less than a month after the onset of symptoms, the
subluxation reduced either spontaneously or after a short period of
traction. Of the seven remaining children, who were seen more than one
month after the onset of symptoms, three eventually needed a posterior
atlanto-axial arthrodesis. Dynamic computed-tomography scans, with the head
rotated maximally to each side, were made for five children, and proved to
be an excellent method of documenting the presence of rotatory
atlanto-axial subluxation.