{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:59:55Z","timestamp":1776697195630,"version":"3.51.2"},"reference-count":27,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,31]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Atlantoaxial rotatory subluxation (AARS) represents a significant cause of acute torticollis in children involving rotational displacement of C1 on C2. Unlike common idiopathic torticollis, AARS represents a true subluxation that frequently necessitates reduction by an experienced provider to restore alignment. Here, we present the case of a child who developed AARS after falling out of bed. A CT scan confirmed acute C1\u2013C2 rotatory subluxation. The patient was successfully treated with closed reduction under sedation in the emergency department by a paediatric spine surgeon, followed by immobilisation in a cervical collar. At the 2-week follow-up, she had achieved a full clinical and radiographic recovery with a return to normal function. This case underscores the necessity of maintaining a high index of suspicion for AARS in traumatic paediatric torticollis, highlights the role of advanced imaging in reaching a definitive diagnosis and confirms that non-operative management can lead to excellent outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2025-271559","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:20:13Z","timestamp":1776694813000},"page":"e271559","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Closed reduction in the emergency room following traumatic C1-C2 rotary subluxation: a paediatric perspective"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7543-5414","authenticated-orcid":false,"given":"Devika A","family":"Shenoy","sequence":"first","affiliation":[{"name":"Duke University Department of Orthopaedic Surgery, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raelynn","family":"Vigue","sequence":"additional","affiliation":[{"name":"Duke University Department of Emergency Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iryna","family":"Ivasyk","sequence":"additional","affiliation":[{"name":"Duke University Department of Orthopaedic Surgery, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily C","family":"Sterrett","sequence":"additional","affiliation":[{"name":"Duke University Department of Emergency Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert K","family":"Lark","sequence":"additional","affiliation":[{"name":"Duke University Department of Orthopaedic Surgery, Durham, North Carolina, 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