ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2021
Comprehensive treatment algorithm for atlanto-axial rotatory fixation (AARF) in children.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Use of halo fixation therapy for traumatic cranio-cervical instability in children: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- A rare cervical complication of Kawasaki disease: a retrospective study of clinical and radiological features.Quantitative imaging in medicine and surgery · 2026Article
- Torticollis in incomplete Kawasaki disease: a case of atlantoaxial rotatory fixation.BJR case reports · 2024Article
- Article
- Delayed atlantoaxial rotatory dislocation in a child with Crohn's disease: illustrative case.Journal of neurosurgery. Case lessons · 2023Article
- Pediatric Spine Trauma.Journal of Korean Neurosurgical Society · 2022Article
- Current management of juvenile idiopathic arthritis affecting the craniovertebral junction.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2020Article
- Grisel's Syndrome in Children: Two Case Reports and Systematic Review of the Literature.Case reports in pediatrics · 2020Article
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8 authors at 2 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAtlanto-axial rotatory fixation (AARF) is an uncommon condition in children presenting with torticollis. Many studies have elaborated on the diagnostic sequence of AARF. However, there is no consensus for the algorithm of management of AARF.
methodsThis study proposes to provide a comprehensive step-by-step guideline which aims to achieve and retain anatomic reduction of the atlanto-axial joint (AAJ). We recommend a 'therapeutic crescendo': closed reduction and immobilization in a rigid cervical collar (step I). In cases of re-dislocation, a second attempt of closed reduction and immobilization in a Halo-jacket (step II). Cases of recurrent dislocations due to persistent instability require open reduction and internal fixation. We present a new surgical technique of transverse suture transfixation (TSF) of C1/C2 (step III). Alternatively, a dorsal stabilization of C1/C2 is indicated after open reduction (step IV). 13 patients with radiologically confirmed AARF were included in this study. These patients were treated as per the above mentioned algorithm. All these patients were serially evaluated with a minimum follow-up of 1 year.
resultsClinical data of 10/13 patients were available for follow-up evaluation at mean 4.6 years after the onset of symptoms. Two patients were managed surgically. We recorded good clinical results in all patients treated according to the algorithm.
conclusionsAARF is a subacute pediatric emergency. Reduction and maintenance of joint congruency of the AAJ are the treatment goals. The comprehensive therapeutic algorithm presented in this study is applicable in patients with AARF to achieve excellent long-term results. LEVEL OF EVIDENCE: IV, Retrospective cohort study. TRIAL REGISTRATION NUMBER: Clinical Trial Registry University of RegensburgZ-2014-0453-4. Registered 01 December 2014.
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