title: Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients.
abstract: Anterior screw fixation of Type II odontoid fractures has been recommended. Only few publications analyse the mechanism of failure in geriatric patients. We reviewed 18 male and 15 female patients aged 65 and above for parameters that influence the development of postoperative loss of correction, delayed union or non-union. Patients were stratified in two groups: 21 cases in Group A (union) and 12 patients in Group B (loss of correction, delayed union, non-union, revision surgery). Statistically significant correlation (p < 0.05) could be detected between failure to heal and: (1) degenerative changes in the atlanto-odontoid joint, (2) severity of osteoporosis in the odontoid process, (3) posterior oblique fracture type, (4) suboptimal fracture reduction, (5) suboptimal position of implant following demanding intraoperative conditions, (6) quality of fracture compression and (7) severity of fracture comminution. The overall morbidity and mortality rates were 29.0 and 8.6%, respectively. Our results indicate that these factors should be addressed regarding the selection of the operative treatment method in the geriatric patient.
authors: Department of Trauma Surgery and Sports Traumatology, Academic Hospital Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria. Michael.osti@lkhf.at
authors: Michael
authors: M
authors: Osti
authors: Helmut
authors: H
authors: Philipp
authors: Berthold
authors: B
authors: Meusburger
authors: Karl Peter
authors: KP
authors: Benedetto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D009809:Odontoid Process / Q000293:injuries* / Q000601:surgery*; D016103:Spinal Fractures / Q000601:surgery*; D016896:Treatment Outcome