Moore TM, Pfiffner TJ.  J Clin Chiropr Pediatr.  1997 Oct;2(2):145-149

ABSTRACT: Objective: The purpose of this article is to present a case of a child who sustained a trauma and presented to a chiropractic campus clinic. The child displayed the “cock robin” position that is typical for atlantoaxial rotary fixation, which allows this entity to be placed in the different diagnosis. The chiropractic management of this child is discussed along with the medical treatment options available. This article also discusses the different types of presentations of rotary fixation and different causes of torticollis in children. Design: A case study Setting: A chiropractic college campus clinic Outcome Measures: Resolution of the condition was determined by resolution of the torticollis and return to normal daily activiities as reported by the child’s guardian. Results: In this case, the child responded favorably to a single chiropractic adjustment along with soft tissue therapy. No complications were noted. The child was released after a short period of follow-up. Conclusion: This case report describes a four-year-old male presented to our clinic after moderate trauma (falling off a bed landing head first) with left lateral head tilt and mild right head rotation. The discussion incorporates torticollis that can be the presenting sign of atlantoaxial rotary fixation. The similarities and differences in the literature between torticollis and atlantoaxial rotary fixation are addressed as well. Any child presenting with a recent upper respiratory infection, sore throat, otitis media, or minor trauma with torticollis is a candidate for consideration of atlantoaxial rotary fixation. The occurrence of atlantoaxial rotary fixation is not an everyday event, nor is the etiology and mechanism certain. The treatment protocol for this patient is discussed and correlation of possible etiologies from the literature is given.

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