Atlantoaxial rotatory fixation (AARF) in children usually resolves with rest or cervical collar immobilization; however, some patients require inpatient traction. Although Glisson traction is widely used, device-related complications in children are not well described. We conducted a retrospective review to determine the incidence and clinical characteristics of medical device-related pressure ulcer (MDRPU) associated with this treatment. Between April 2001 and March 2025, 177 children with AARF were treated at our institution, and 53 patients (29.9%) required Glisson traction. The cohort comprised 20 boys and 33 girls with a mean age of 6.8 years (range, 1–14 years). Median body weight was 21 kg (IQR, 18–27). The mean traction load was 1,615 g (range, 500–5,000 g), corresponding to 6.1% of body weight, and the median duration was 14 days (IQR, 8–17). All patients improved without surgical intervention. MDRPU developed in 7 patients (13.2%), mainly at the lower jaw. No skin complications occurred in patients treated without traction. All ulcers healed conservatively without discontinuation of traction. Traction was initiated with a low load according to body size and pain tolerance, but improvement sometimes occurred before adjustment, making the optimal load unclear. The relatively high MDRPU incidence indicates limitations of prolonged traction. Routine skin protection and careful monitoring should be considered when Glisson traction is applied in children.