Torticollis due to atlantoaxial rotatory fixation.

Torticollis due to atlantoaxial rotatory fixation (AARF) is rare. Most cases are idiopathic or occur after infection or minor trauma. AARF can cause neurologic deficits, and patients often present with torticollis that fails to resolve. AARF should be excluded before idiopathic spasmodic torticollis is diagnosed. Computed tomography helps in confirming AARF, and early diagnosis can improve outcomes, although treatment is debatable. We present three children and one adult with AARF and review the literature.