Chiropractic correction of atlantoaxial rotatory fixation. 1996

G A Knutson

OBJECTIVE To discuss the diagnosis, management and possible mechanism of atlantoaxial rotatory fixation. METHODS An 11-yr-old girl with significant head tilt of 7 months' duration sought chiropractic evaluation. Her history included indirect head and neck trauma from a motor vehicle accident and prior manipulative and therapeutic treatment. There was minimal muscular hypertonicity, except for the sternocleidomastoid muscle on the side opposite head tilt. The head seemed to be locked in a classic "cock robin" position. Radiological examination revealed asymmetry of the atlanto-odontoid interval, suggesting occipital-atlantoaxial joint dysfunction. A diagnosis of atlantoaxial rotatory fixation was made. RESULTS Treatment included vectored/linear, upper cervical, high-velocity, low-amplitude chiropractic manipulation of the atlas vertebra, mobilizing manipulation and stretching exercises. Complete resolution occurred. CONCLUSIONS This single case study suggests that chiropractic manipulation may be a viable treatment option for atlantoaxial rotatory fixation. Further investigation into manipulation as a treatment should be pursued.

UI MeSH Term Description Entries
D008349 Manipulation, Orthopedic The planned and carefully managed manual movement of the musculoskeletal system, extremities, and spine to produce increased motion. The term is sometimes used to denote a precise sequence of movements of a joint to determine the presence of disease or to reduce a dislocation. In the case of fractures, orthopedic manipulation can produce better position and alignment of the fracture. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p264) Orthopedic Manipulation
D010147 Pain Measurement Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies. Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001268 Atlanto-Axial Joint The joint involving the CERVICAL ATLAS and axis bones. Atlanto Axial Joint,Atlantoaxial Joint,Atlanto Axial Joints,Atlanto-Axial Joints,Atlantoaxial Joints,Joint, Atlanto Axial,Joint, Atlanto-Axial,Joint, Atlantoaxial,Joints, Atlanto Axial,Joints, Atlanto-Axial,Joints, Atlantoaxial
D013122 Spinal Diseases Diseases involving the SPINE. Disease, Spinal,Diseases, Spinal,Spinal Disease
D016059 Range of Motion, Articular The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES. Passive Range of Motion,Joint Flexibility,Joint Range of Motion,Range of Motion,Flexibility, Joint

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