title: Management of odontoid fractures with anterior screw fixation.
abstract: Type II odontoid fractures are prone to undergo nonunion. Stabilization of such fractures with anterior screw fixation provides rigid internal fixation and preserves C1-C2 motion. During a 5-year period, 17 patients with displaced type II fractures of the odontoid were treated Thirteen were male and four were female with a mean age of 38.2 years. All patients were operated on for anterior screw fixation within a mean of 10.1 days from injury. Postoperatively, the patients were evaluated clinically and radiologically at regular intervals. With a mean follow-up of 3.2 years, union was observed in 16 of 17 patients (94%). One patient developed nonunion for which he required C1-C2 fusion subsequently. Screw back-out by a few millimeters was seen in another patient resulting in mild restriction of neck movements. No approach-related complications were noted. Anterior odontoid screw fixation has relatively low complication and high fusion rates. It not only restores normal anatomy but also gives better functional results by preserving intrinsic C1-C2 motion. Thus it should be considered the treatment of choice in acute displaced type II odontoid fractures.
authors.affiliation: Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India. arunbhanot@rediffmail.com
authors.forename: Arun
authors.initials: A
authors.lastname: Bhanot
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sawhney
authors.forename: Rishi
authors.initials: R
authors.lastname: Kaushal
authors.forename: Amulya Kumar
authors.initials: AK
authors.lastname: Aggarwal
authors.forename: Raj
authors.initials: R
authors.lastname: Bahadur
mesh_terms: D000293:Adolescent; D000328:Adult; D000762:Anesthesia Recovery Period; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000293:injuries*; D016059:Range of Motion, Articular; D016103:Spinal Fractures / Q000145:classification / Q000503:physiopathology / Q000601:surgery*