Atlantoaxial rotary deformities

Persistent torticollis in younger patients, particularly after trivial trauma or an upper respiratory tract infection, suggests a diagnosis of atlantoaxial rotary fixation. The diagnosis can be confirmed by cineroentgenography. Anterior displacement of the atlas, indicating a deficient transverse ligament, should be ruled out by flexion-extension lateral roentgenograms. If conservative management fails to achieve reduction or is followed by a recurrence of the deformity, arthrodesis is indicated.