Odontoid fractures in the elderly.
A review of 35 patients > 60 years of age with odontoid fractures showed that a type II injury (Anderson and D'Alonso) was the most common fracture pattern (82% of cases). On the basis of mechanism of injury and sex incidence, we deduced that osteopenia is a contributory factor in the occurrence of odontoid fractures. A fall in a domestic setting was the cause in 53%. The peg was posteriorly displaced in 88% of type II fractures, and primary union occurred in 23%. The incidence of concomitant spinal cord injury with type II fractures was higher in older patients than it was in those < 60 years of age. The outcome for these patients was largely determined by their neurological status at presentation. Myelopathy as a late complication of nonunion was not observed in nine patients with an average follow-up of 21 months. The data suggest that vigorous attempts to secure both primary union and a sound arthrodesis for non-union are questionable in the elderly except in unusual circumstances.
Ryan
M D
MD
Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, Sydney, Australia.
Taylor
T K
TK
D000368:Aged; D000369:Aged, 80 and over; D001851:Bone Diseases, Metabolic / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005599:Fractures, Ununited; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000293:injuries*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome