FIXED ATLANTOAXIAL ROTATORY SUBLUXATION - A FREQUENTLY OVERLOOKED CAUSE OF TORTICOLLIS IN CHILDREN

Two patients aged 2 and 13 years old are presented, both of whom had t orticollis caused by atlanto-axial rotatory subluxation. The correct d iagnosis was delayed for 3 months as a result of inappropriate radiolo gic evaluation. In each patient increased atlanto-dental distance, ant erolisthesis of the atlas, and malrotation of the atlas relative to th e axis were found on a simple lateral projection. Treatment, consistin g in reduction under anaesthesia and plaster fixation for 8 weeks, was successful in the smaller child, whereas redislocation occurred in th e other patient, It is imperative to exclude by early radiological exa mination skeletal abnormality in the presence of persisting acquired t orticollis in children.