Fixed rotatory subluxation of the atlanto-axial joint in polytraumatized patients

Traumatic atlanto-axial instabilities are rare entities in cervical spine i njuries. There may be only subtle abnormal findings by plain radiographs, f requently resulting in a missed or delayed diagnosis. We report a polytraum atized patient with severe maxillofacial injuries, where preliminary radiol ogical studies failed to verify rotatory instability of the atlanto-axial j oint. A definite diagnosis was only established by further imaging studies, including CT scan reformations.