title: Rigid cervical collar treatment for geriatric type II odontoid fractures.
abstract: OBJECTIVE
  To evaluate fracture healing, functional outcomes, complications, and mortality associated with rigid cervical collars.
  
  
  METHODS
  Thirty-four patients with <50% odontoid displacement were treated with a rigid cervical collar for 12 weeks (Average age = 84 years). Outcome scores were compared with a group of 40 age-matched control subjects (Average age 79.3).
  
  
  RESULTS
  At average 14.9-month follow-up, only 6% demonstrated radiographic evidence of fracture healing and 70% had mobile odontoid nonunion. NDI scores indicated only mild disability, pain scores were low, and neither differed significantly from age-matched controls. Mobile odontoid nonunion was not associated with higher levels of disability or neck pain. Mortality rate was 11.8%. Treatment complications occurred in 6% of patients.
  
  
  CONCLUSIONS
  Odontoid nonunion and instability are high in geriatric patients treated with a rigid cervical collar. Fracture healing and stability did not correlate with improved outcomes. Outcomes did not differ significantly from age-matched cohorts.
authors.affiliation: Orthopaedics and Rehabilitation, University of Rochester Medical Center, 601 Elmwood Ave., Box 665, Rochester, NY 14642, USA. Robert_Molinari@URMC.Rochester.edu
authors.forename: Robert W
authors.initials: RW
authors.lastname: Molinari
authors.forename: Oner A
authors.initials: OA
authors.lastname: Khera
authors.forename: William L
authors.initials: WL
authors.lastname: Gruhn
authors.forename: Ryan W
authors.initials: RW
authors.lastname: McAssey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002574:Cervical Vertebrae; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D017759:Fractures, Malunited / Q000453:epidemiology; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries*; D009989:Orthotic Devices; D011859:Radiography; D016896:Treatment Outcome
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