A case of atlanto-axial rotatory fixation associated with Jefferson's fracture

The authors present a case of atlanto-axial rotatory fixation associated with Jefferson's fracture. A 52-year-old man was admitted to our hospital complaining of severe neck pain and torticollis after a traffic accident. Cervical x-ray films showed fracture of the atlas. CT scans demonstrated traumatic subarachnoid hemorrhage and atlanto-axial rotatory fixation. The patient was managed with skull traction and reposition was achieved. Although he was maintained in a halo device for 4 months, rotary fixation recurred. He underwent posterior fusion between the atlas and axis. We review the literature and discuss the diagnostic problems and methods of treatment for atlanto-axial rotatory fixation.