title: Non-operative treatment in children and adolescents with atlantoaxial rotatory subluxation.
abstract: OBJECTIVE
  Atlantoaxial rotatory subluxation (AARS) is an uncommon lesion seen mainly in children and adolescents. A retrospective analysis of 12 patients with AARS treated non-operatively is presented in this study.
  
  
  METHODS
  Twelve patients with AARS who were treated non-operatively were evaluated retrospectively in terms of recent trauma and respiratory tract infection history, accompanying injuries, radiological findings, duration of symptoms, amount and duration of traction and clinical results of the treatment.
  
  
  RESULTS
  Traumatic AARS was present in 8 patients. No evidence of trauma was found in 4 patients. Type I subluxations in 10 and type II subluxations in 2 patients were found according to the Fielding and Hawkins classification. All patients were treated using bed-side mentooccipital tractions. The mean duration of bed-side mentooccipital traction was 3,75 days and the mean amount of load was 1.8 kg. All patients were kept in Philadelphia collars for additional 3 weeks after the clinical recovery. No limitations and pain in head movements were present in any patient at the sixth month follow-up examinations.
  
  
  CONCLUSIONS
  Paediatric patients with neck pain and torticollis should be investigated concerning trauma and recent respiratory tract infection history in order to avoid any delay in diagnosis of a possible AARS.
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Ciftdemir
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Copuroğlu
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Ozcan
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: Ayşe Ovul
authors.initials: AO
authors.lastname: Ulusam
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, Trakya University, Edirne, Turkey.
authors.forename: Erol
authors.initials: E
authors.lastname: Yalnız
keywords: Atlanto-axial joint; neck pain; torticollis