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Rehabilitation Practice and Science

Abstract

Background Atlantoaxial Rotatory Fixation (AARF) is a relatively rare condition, most diagnosed in the children, with common etiologies including minor trauma and upper respiratory infections. However, cases of AARF resulting from congenital strabismus are yet to be reported. Objective We aimed to underscore the uncommon association between AARF and congenital strabismus and to evaluate the effectiveness of halter traction. Method In this case report, we present an 11-year-old male patient with a history of congenital strabismus, which led to the development of AARF. Results The patient was initially observed to have torticollis and strabismus at the age of 4 months. At the age of 4 years, he presented to the orthopedic clinic with a pronounced head tilt. A computed tomography scan confirmed the diagnosis of atlantoaxial rotatory fixation. Following a 4-week regimen of halter traction therapy, he was prescribed daytime usage of a four-post cervical brace and continued with overnight traction at home after discharge. Subsequent follow-up with open mouth X-ray scan showed improved alignment of the C1-C2 vertebrae and a noticeable decrease in head tilt. Conclusions This literature highlights the effectiveness of halter traction in treating AARF, even in patients with long-standing symptoms. It also suggests that abnormal head position resulting from congenital strabismus could be a less recognized cause of AARF, requiring further attention in clinical assessments.

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