Objective: The purpose of this study was to report on a rare case of progressive chronic rotatory subluxation of Cl-C2
(Fielding and Hawkins type TTT) which was successfully treated non-surgically and to provide a review of the related literature.

Materials and Methods: Retrospective case report

Results: The authors report on a patient who presented with persistent progressive cervical rotation following 5 months of partial treatment. Cl-C2 reduction, demonstrated by the symmetry of the lateral atlantodental interval (ADT)in radiographs of the C-spine in open mouth view, was
achieved after 3 weeks of continuous halter traction. Following that procedure, 4- poster bracing was used to immobilize the neck for 3 months. The stabilization of the neck permitted normal range of motion.

Conclusion: Based on this case,the authors suggest full time continuous halter traction is an option for reduction and 4- poster brace is an option for immobilization of chronic atlantoaxial rotatory subluxation in cases with no facet joint deformity.

Keywords: Chronic Cl-C2 rotatory subluxation, Grisel syndrome, Reduction, Continuous halter traction