Background: Atlantoaxial rotatory fixation (AARF) comprises a spectrum of abnormal rotational relationships between C1 (atlas) and C2 (axis). We aimed to evaluate the efficacy and long-term clinical outcomes of halter traction in treating patients diagnosed with primary AARF.
Methods:We included patients <18 years of age who presented with new-onset painful torticollis, neck pain, and sternocleidomastoid muscle spasm, had an AARF diagnosis confirmed by use of 3-dimensional dynamic computed tomography, received in-hospital cervical halter traction under our treatment protocol, and were followed for ‡12 months. Radiographic and long-term clinical outcomes were analyzed.Results: A total of 43 patients (31 male and 12 female; average age of 7.9 years) satisfied the inclusion criteria. There
Material and Methods
Inclusion and Exclusion CriteriaT his was a retrospective cohort study performed at a single Level-I trauma center. Considered for inclusion were pediatric patients who, from 2007 to 2020, presented with newonset painful torticollis (cock-robin position), neck pain, and sternocleidomastoid (SCM) muscle spasm, were screened by C1-C2 open-mouth radiography, and were diagnosed with AARF (Type 1, Type 2, or Type 3, Pang and Li classification 7,8 ) using 3-dimensional dynamic computed tomography (3D dynamic CT). Excluded were patients with genetic disorders, congenital disorders, or developmental malformations, a Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G782).