Anterior screw fixation for a pediatric odontoid nonunion: a case report.
METHODS
A case of an odontoid nonunion in a child treated with anterior screw fixation.


OBJECTIVE
To demonstrate that an anterior screw procedure can be performed with an odontoid nonunion with resultant fusion to maintain range of motion.


METHODS
A 15-year-old boy presented with pain in his neck following a rugby football injury. Admission plain radiographs and computed tomography scan demonstrated an odontoid nonunion. Radiographs of a previous cervical spine injury 2 years before demonstrated a missed odontoid fracture.


RESULTS
The child was initially treated conservatively with halo vest immobilization, which did not result in healing. Direct anterior screw fixation was performed and the fracture united 5 months following surgery.


CONCLUSIONS
The nonunion was asymptomatic for 2 years until the second injury when it became clinically symptomatic. It did not respond to conservative treatment and was unstable on screening requiring operative intervention.


CONCLUSIONS
Very few cases have been reported of pediatric odontoid nonunions. If the fracture pattern allows, then direct anterior screw fixation should be considered in order to maintain range of motion at the atlantoaxial articulation.
Jones
Alwyn
A
University of Wales Hospital, Heath Park, Cardiff, Wales. alwyn.j@virgin.net
Mehta
Jwalant
J
Fagan
Dan
D
Ahuja
Sashin
S
Grant
Andrew
A
Davies
Paul
P
D000293:Adolescent; D001863:Bone Screws; D005538:Football / Q000293:injuries; D006801:Humans; D008297:Male; D009809:Odontoid Process / Q000293:injuries* / Q000502:physiology*; D016059:Range of Motion, Articular; D016103:Spinal Fractures / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome