title: Treatment of type-two odontoid fractures in halothoracic vests.
abstract: We treated 22 patients with type-two odontoid fractures in halothoracic vests for six to eight weeks followed by a Philadelphia collar for four weeks. Eighteen patients were reviewed by questionnaire and radiography at a mean of 40 months after injury. We assessed union, fracture position, the degree of permanent pain and stiffness, satisfaction with the treatment and the outcome. The overall union rate was 82%. Posterior malunion with residual posterior displacement or angulation was associated with a higher incidence of persisting pain. The position at union did not correlate with the residual cervical stiffness. Fractures failed to unite in four patients (18%) none of whom had late neurological sequelae, although they had more late pain. There were associations between the development of nonunion and an extension-type injury, age over 65 years and delay in diagnosis.
authors.affiliation: Austin and Repatriation Medical Centre, University of Melbourne, Heidelberg, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Stoney
authors.forename: J
authors.initials: J
authors.lastname: O'Brien
authors.forename: P
authors.initials: P
authors.lastname: Wilde
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001915:Braces; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation*; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000209:etiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D015994:Incidence; D004204:Joint Dislocations / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011859:Radiography; D013122:Spinal Diseases / Q000209:etiology; D016103:Spinal Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome