Affiliation:
1. Department of Neurosurgery, The Medical College of Wisconsin, and Institute of Trauma and Emergency Medicine of The Milwaukee Regional Medical Center, Milwaukee, and Veterans Administration Medical Center, Wood, Wisconsin
Abstract
Abstract
Fifty-one adults with odontoid fractures were treated between 1966 and 1979. Approximately 50% had additional trauma; over half of the patients were younger than 40 years old. Three patients presented with myelopathy: 1 was complete at C-2 and the others recovered. Cervical roentgenograms were initially considered normal in 4 patients. The fracture was through the base of the odontoid process (Type 2) in 49 patients and was into the body of C-2 (Type 3) in 2 patients. Thirty-four patients underwent early posterior cervical fusion, whereas the others were treated initially with external immobilization. Only the 2 patients with Type 3 fractures healed in Minerva casts. All 15 Type 2 fractures initially treated conservatively failed to heal and were fused. There were no age, sex, or radiological characteristics (other than fracture location) peculiar to the nonunton group. Two patients died after operation, and there was 1 minor infection in an iliac crest donor site. All patients who were operated upon demonstrated evidence of fusion within 6 weeks after operation; 16 demonstrated healing of the fracture at 6 months. After follow-up ranging from 16 months to 15 years, 7 patients complain of neck pain, of whom 6 do not require regular analgesics. Of 40 patients tested, 7 have evidence of decreased range of motion in the neck, of whom 6 have loss of less than 15% of normal motion. Traction followed by posterior cervical fusion is effective treatment for Type 2 odontoid fractures. The surgical and long term morbidity is low, and satisfactory fusion can be expected.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Clinical Neurology,Surgery
Cited by
68 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献