title: Combined Type II Odontoid Fracture With Axis Anterior Arch Fracture: A Case Report in an Elderly Patient.
abstract: Associated fractures of the atlas and axis are frequent, particularly in the elderly patients following a simple low-energy fall. This injury can be easily misdiagnosed on initial plain radiographs, and therefore computed tomography scan is a useful adjunct in patients with a degenerative spine. There is still no consensus as to the optimal treatment of combined axis-atlas fractures, and the majority of authors propose a therapeutic strategy dependent on the odontoid fracture pattern. We describe a combined atlas and axis fracture in a 92-year-old patient who was managed with nonoperative treatment in a rigid collar. The association of C1 anterior arch with a C2 type II odontoid fracture is a rare combination, which to our knowledge has never been reported following nonoperative treatment. There was a good functional outcome at 1-year follow-up with the fracture progressing to a fibrous nonunion of the odontoid process.
authors.affiliation: Department of Orhtopaedic and Trauma Surgery, Hospital de Mataró, Mataró, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Malagelada
authors.affiliation: Department of Orthopaedics, The Royal London Hospital, London, United Kingdom.
authors.forename: Saket
authors.initials: S
authors.lastname: Tibrewal
authors.affiliation: Department of Orhtopaedic and Trauma Surgery, Hospital de Mataró, Mataró, Barcelona, Spain.
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Lucar
authors.affiliation: Department of Orthopaedics, The Royal London Hospital, London, United Kingdom.
authors.forename: Luckshmana
authors.initials: L
authors.lastname: Jeyaseelan
authors.affiliation: Department of Spinal Surgery, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
authors.forename: Amr
authors.initials: A
authors.lastname: Fahmy
authors.affiliation: Department of Orhtopaedic and Trauma Surgery, Hospital de Mataró, Mataró, Barcelona, Spain.
authors.forename: Jose Sanchez
authors.initials: JS
authors.lastname: Gonzalez
keywords: atlas; axis; computed tomography; elderly patients; fracture; nonunion