Traumatic Atlantoaxial Subluxation in Children

We report four children who sustained traumatic atlantoaxial subluxation without a rotatory component, underlying congenital anomaly, or inflammatory cause. Three patients were involved in motor vehicle accidents as pedestrians, and one sustained a rugby injury to his neck. Only one patient sustained an associated head injury. Two patients had neurologic signs on admission directly attributable to the atlantoaxial subluxation. The signs resolved after reduction and stabilization of the subluxation. Three patients were treated conservatively and one operatively. To date, all four patients have had a satisfactory outcome.