Odontoid fractures. A rational approach to treatment.
Twenty-three adults with fractures of the odontoid process are reviewed. Te possible reasons for the high rate of non-union in reported series are considered: these include the type of fracture, its displacement, the presence of a gap at the fracture site, imperfect reduction and inadequate immobilisation. Type 2 fractures (at the base of the odontoid process) are the commonest and also the most liable to nonunion. In their treatment, reduction is important; as seen in the lateral radiograph at least two-thirds of the fracture surfaces should be in contact. Skull traction is not advised and halo-cast fixation is the treatment of choice; with this method 87.5 per cent of recent odontoid fractures united.
D000328:Adult; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000293:injuries*; D002370:Casts, Surgical; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014143:Traction