This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Govender, S. Articles by Kumar, K. P. S. Search for Related Content PubMed PubMed Citation Articles by Govender, S. Articles by Kumar, K. P. S.

Staged reduction and stabilisation in chronic atlantoaxial rotatory fixation

Department of Orthopaedic Surgery, Nelson R. Mandela School of Medicine, Faculty of Health Sciences, University of Natal, Private Bag X07, 4031 Congella, Durban, Republic of South Africa.

Correspondence should be sent to Professor S. Govender.

We present seven children with atlantoaxial rotatory fixation (AARF) of more than three months’ duration after an injury to the upper cervical spine. The deformity was irreducible by skull traction. MRI and MR angiography (MRA) of the vertebral arteries were performed in four children. The patients were neurologically intact. Thrombosis of the ipsilateral vertebral artery was noted in two patients. The deformity was gradually corrected and stabilised after transoral release of the atlantoaxial complex, skull traction and posterior atlantoaxial fusion. Soft-tissue interposition and contractures within the atlantoaxial complex prevented closed reduction. MRI and MRA of the vertebral arteries were useful in elucidating the pathology of chronic atlantoaxial rotatory fixation.