{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:57:59Z","timestamp":1785463079184,"version":"3.56.0"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009399","name":"Peking University Third Hospital","doi-asserted-by":"crossref","award":["BYSYDL202106"],"award-info":[{"award-number":["BYSYDL202106"]}],"id":[{"id":"10.13039\/501100009399","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\u00bb Atlantoaxial rotatory fixation (AARF), also known as atlantoaxial rotatory subluxation (AARS), is an uncommon cervical disorder that occurs predominantly in children and typically presents with painful torticollis in the characteristic \u201ccock-robin\u201d position. It is frequently associated with upper respiratory infections, minor trauma, or recent otolaryngologic procedures.<\/jats:p>\n                  <jats:p>\u00bb Computed tomography (CT) is the gold standard for diagnosing AARF because it provides accurate assessment of atlantoaxial alignment and rotational deformity.<\/jats:p>\n                  <jats:p>\u00bb Several classification systems have been proposed to characterize AARF, including the Fielding and Hawkins classification, the Pang\u2013Li dynamic CT classification, and the PUTH classification, which incorporates reducibility to help guide treatment decisions.<\/jats:p>\n                  <jats:p>\u00bb Management strategies range from nonoperative treatments\u2014such as cervical immobilization and traction\u2014to more invasive nonoperative interventions, including manipulation under anesthesia or halo traction, depending on symptom duration and reducibility.<\/jats:p>\n                  <jats:p>\u00bb Surgical stabilization, most commonly posterior C1\u2013C2 fusion using techniques such as the Goel\u2013Harms construct, is generally reserved for irreducible deformities or cases that fail conservative management, highlighting the need for standardized diagnostic and treatment algorithms.<\/jats:p>","DOI":"10.2106\/jbjs.oa.26.00081","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:00:28Z","timestamp":1784325628000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Atlantoaxial Rotatory Fixation: Current Challenges and Advances in Diagnosis and Management"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1260-5561","authenticated-orcid":false,"given":"Zirui","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Peking University Third Hospital, Beijing, 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