{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:26:31Z","timestamp":1787775991447,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Atlanto-axial rotary subluxation (AARS) is rare but recognized as a significant cervical spine injury following a fall or physical impact on the head or neck in children aged 5\u201315 years. Trampoline use has been increasing among children, as have the trampoline-related injuries (TRI). We present a case series of AARS following trampoline injuries, highlighting clinical presentation, diagnosis, and management, especially in an emergency setting. We report four children with an average age of 8.5 years (range 6\u201312 years) presented to our hospital emergency service with neck pain and torticollis following a TRI. The diagnosis was confirmed through X-ray and computed tomography imaging, revealing Fielding and Hawkins type 1 AARS. Conservative treatment with analgesics, muscle relaxants, and a cervical collar led to recovery in three cases, while one required halter cervical traction for persistent deformity. All patients recovered completely, with no long-term complications. AARS in children is largely a type 1 injury with a favorable prognosis. Early recognition and management are crucial in preventing complications. The increasing incidence of neck injuries caused by trampoline use in children necessitates strict safety regulations regarding its use.<\/jats:p>","DOI":"10.4103\/jcvjs.jcvjs_154_24","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:02:58Z","timestamp":1736917378000},"page":"515-518","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis"],"prefix":"10.4103","volume":"15","author":[{"given":"Vijayanth","family":"Kanagaraju","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Boston Medical Center, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri Deepa Kolathupalayam","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Physician, NMC Royal Hospital, Dubai Investments Park 1, Dubai, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherief","family":"Elsayed","sequence":"additional","affiliation":[{"name":"Spine Surgery, Emirates Speciality Hospital, Dubai, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi Kumar","family":"Ponnappan","sequence":"additional","affiliation":[{"name":"Spine Surgery, Cooper Medical School, Rowan University, Camden, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"R1-20250115","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1542\/peds.89.5.849","article-title":"Trampolines revisited: A review of 114 pediatric recreational trampoline injuries","volume":"89","author":"Woodward","year":"1992","journal-title":"Pediatrics"},{"key":"R2-20250115","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/BPO.0000000000000189","article-title":"Fractures from trampolines: Results from a national database, 2002 to 2011","volume":"34","author":"Loder","year":"2014","journal-title":"J Pediatr Orthop"},{"key":"R3-20250115","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1159\/000028929","article-title":"Trampoline injuries of the cervical spine","volume":"32","author":"Brown","year":"2000","journal-title":"Pediatr Neurosurg"},{"key":"R4-20250115","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1093\/pch\/14.2.84","article-title":"Children presenting to a Canadian hospital with trampoline-related cervical spine injuries","volume":"14","author":"Leonard","year":"2009","journal-title":"Paediatr Child Health"},{"key":"R5-20250115","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2106\/00004623-197759010-00005","article-title":"Atlanto-axial rotatory fixation. 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