title: Oblique Axis Body Fracture: An Unstable Subtype of Anderson Type III Odontoid Fractures-Apropos of Two Cases.
abstract: Purpose. Anderson type III odontoid fractures have traditionally been considered stable and treated conservatively. However, unstable cases with unfavorable results following conservative treatment have been reported. Methods. We present the cases of two patients who sustained minimally displaced Anderson type III fractures with a characteristic fracture pattern that we refer to as "oblique type axis body fracture." Results. The female patients aged 90 and 72 years, respectively, were both diagnosed with minimally displaced Anderson type III fractures. Both fractures had a characteristic "oblique type" fracture pattern. The first patient was treated conservatively with cervical spine immobilization in a semirigid collar. However, gross displacement was noted at the 6-week follow-up visit. The second patient was therefore treated operatively by C1-C3/4 posterior fusion and the course was uneventful. Conclusions. Oblique type axis body fractures resemble a highly unstable subtype of Anderson type III fractures with the potential of severe secondary deformity following conservative treatment, irrespective of initial grade of displacement. The authors therefore warrant a high index of suspicion for this injury and suggest early operative stabilization.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Freiburg University Medical Centre, 79106 Freiburg im Breisgau, Germany.
authors.forename: Hirokazu
authors.identifier: 0000-0001-7137-8076
authors.initials: H
authors.lastname: Takai
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Freiburg University Medical Centre, 79106 Freiburg im Breisgau, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Konstantinidis
authors.affiliation: Department of Orthopaedics and Traumatology, Odense University Hospital, Sonder Boulevard 29, 5000 Odense C, Denmark.
authors.forename: Hagen
authors.initials: H
authors.lastname: Schmal
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Freiburg University Medical Centre, 79106 Freiburg im Breisgau, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Helwig
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Freiburg University Medical Centre, 79106 Freiburg im Breisgau, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Knöller
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Freiburg University Medical Centre, 79106 Freiburg im Breisgau, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Südkamp
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Freiburg University Medical Centre, 79106 Freiburg im Breisgau, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Hauschild