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Short Communication Volume 10 Issue 6
Odontoid fractures
Behzad Saberi
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Iranian Medical Council, Iran
Correspondence: Behzad Saberi, Member of the Iranian Medical Council no 24, Shahed South Molasadra Street, Esfahan, Iran, Tel (00)98-(0)9131263487
Received: November 18, 2018 | Published: December 26, 2018
Citation: Saberi B. Odontoid fractures. MOJ Orthop Rheumatol. 2018;10(6):397. DOI: 10.15406/mojor.2018.10.00456
Short communication
A young man with no previous history of any chronic head and neck pain or related neurological problems, was presented with shoulder and neck pain following a motor vehicle accident. There was no radiating pain but the pain severity was worsening following any motion in the neck and was alleviating during neck and shoulder stabilization. On radiologic studies, Type II of the Odontoid fracture of the Axis was confirmed as the diagnosis.
Brief review on odontoid fractures:
Fractures of the Axis as the second cervical vertebrae, include hangman’s fractures, odontoid fractures and miscellaneous ones.1,2–4
In this study we will have a brief review on Odontoid fractures.
There are three types of Odontoid fractures including Types I, II and III.
In Type I, only the "tip" of the dens is involved. This type of fracture is a rare one.
In Type II, "neck" of the dens in involved.
In Type III, "base" of the dens and body of the Axis are involved.
Type II fractures are the most frequent ones – approximately two-thirds of all odontoid fractures –
CT and MRI scans can be used to detect such fractures and the treatment can be done based on two factors: "Bone displacement amount" and "Injury of ligaments".
Type I fractures can be treated with a semirigid orthosis.
Type II fractures can be treated based on the amount of displacement which 6 mm is used as a reference in this regard. In case the displacement amount would be less than 6 mm, a halo brace, rigid or semirigid orthosis can be used. In more than 6 mm displacement, Internal fixation should be used. 3,4
In case this type of fractures would be occurred joined with tranverse ligament disruption,5 "Atlas-Axis fusion" surgery should be employed for treatment.
Type III fractures can be treated with an orthosis. Surgery can be done in case of nonunion persistence for more than three months.
References
- Hadley MN, Dickman CA, Browner CM, et al. Acute traumatic atlas fractures: management and long term outcome. Neurosurgery. 1988;23(1):31–35.
- Effendi B, Roy D, Cornish B, et al. Fractures of the ring of the axis. A classification based on the analysis of 131cases. J Bone Joint Surg Br. 1981;63-B(3):319–327.
- Hadley MN, Browner CM, Liu SS, et al. New subtype of acute odontoid fractures (type IIA). Neurosurgery. 1988;22(1 Pt 1):67–71.
- Greene KA, Dickman CA, Marciano FF, et al. Acute axis fractures. Analysis of management and outcome in 340 consecutive cases. Spine. 1997;22(16):1843–1852.
- Greene KA, Dickman CA, Marciano FF, et al. Transverse atlantal ligament disruption associated with odontoid fractures. Spine 1994;19(20):2307–2314.
©2018 Saberi. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.