Atlanto-axial rotatory fixation and fracture of the clavicle. An association and a classification

J Bone Joint Surg Br. 1990 Jan;72(1):72-5. doi: 10.1302/0301-620X.72B1.2298798.


Five children with atlanto-axial rotatory fixation (AARF) in association with fractures of the clavicle are described. It is postulated that the rotary fixation is a direct result of the trauma which produces the fracture. The importance of early diagnosis is stressed, since delayed diagnosis may lead to chronic deformity. Early diagnosis depends on awareness of the possibility of AARF, and either fluoroscoping the patient in order to take appropriate spot films or imaging the atlanto-axial joint by CT. A simple classification of AARF is proposed based on distinct radiological features which differentiate subluxation from dislocation.

Publication types

  • Case Reports

MeSH terms

  • Atlanto-Axial Joint / diagnostic imaging
  • Atlanto-Axial Joint / injuries*
  • Atlanto-Axial Joint / surgery
  • Child
  • Clavicle / injuries*
  • Female
  • Fractures, Bone / complications*
  • Humans
  • Joint Dislocations / classification
  • Joint Dislocations / complications*
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / surgery
  • Tomography, X-Ray Computed
  • Torticollis / etiology