Reduction of Chronic C1-C2 Rotatory Subluxation using Continuous Cervical Halter Traction: A Case Report and Literature Review
Sombat Kunakornsawat MD1, Kanthika Wasinpongwanich MD1,2, Tinnakorn Pluemvitayaporn MD1, Pritsanai Pruttikul MD1, Chaiwat Piyakulkaew MD1
Affiliation : 1 Center of Excellence in Orthopedics, Lerdsin Hospital, Bangkok, Thailand 2 School of Orthopaedics, Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima, Thailand
Objective : The purpose of this study was to report on a rare case of progressive chronic rotatory subluxation of C1-C2
(Fielding and Hawkins type III) 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. C1-C2 reduction, demonstrated by the symmetry of the lateral atlantodental interval (ADI)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 C1-C2 rotatory subluxation, Grisel syndrome, Reduction, Continuous halter traction
