title: Recurrent atlantoaxial rotatory fixation in children: a rare complication of a rare condition. Report of four cases.
abstract: Atlantoaxial rotatory fixation (AARF) is an uncommon condition of childhood. Occasionally AARF may recur. The authors describe the cases of four patients with recurrent AARF (RAARF). The probable cause of the RAARF and operative procedure selected are discussed. In three cases, attempts were made to stabilize the atlantoaxial complex rather than to perform fusion to preserve the function of the joint complex. Joint stabilization is performed by incorporating a "check ligament" into the joint construct between the axial spinous process and the atlantal lateral mass. The authors believe this technique of joint stabilization augments the strength of the joint, allowing normal, but preventing excessive, rotation, until the joint reaches physiological maturity.
authors.affiliation: Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
authors.forename: John E
authors.initials: JE
authors.lastname: Crossman
authors.forename: Dominic
authors.initials: D
authors.lastname: Thompson
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hayward
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Ransford
authors.forename: H Alan
authors.initials: HA
authors.lastname: Crockard
mesh_terms: D001268:Atlanto-Axial Joint; D001368:Axis, Cervical Vertebra / Q000601:surgery*; D001863:Bone Screws; D001270:Cervical Atlas / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000209:etiology* / Q000601:surgery*; D004204:Joint Dislocations / Q000150:complications*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D013536:Suture Techniques