Atlantoaxial rotatory subluxation: realignment and discharge within 48 h

Atlantoaxial rotatory fixation is a rare disorder in which the atlas gets fixed in a position normally achieved during rotation. Patients present with painful torticollis and a typical 'cock robin' position of the head: rotation, slight flexion and head tilting contralateral to the direction of rotation. During childhood, laxity of the ligamentous apparatus and joint cups allows a wider range of motion and rotation within these joints. Traumatic effects contribute to subluxation at relevant degree (Fiedling type 2 and higher) for which skeletal traction is necessary. Duration of skeletal traction can be reduced to a minimum (24 h), as seen in this patient, when diagnosis is set as early as possible.