Type III odontoid fractures: A subgroup analysis of complex, high-energy fractures treated with external immobilization

Journal of Craniovertebral Junction and Spine
Thomas E NiemeierSteven M Theiss

Abstract

Retrospective cohort study. Type III odontoid fractures are classically treated nonoperatively, yet, the current literature on Type III odontoid fractures includes fractures of multiple etiologies and fracture morphologies. We hypothesize that a subgroup of complex, Type III fractures caused by high-energy mechanisms are more likely to fail nonoperative treatment. Acute Type III odontoid fractures were identified at a single institution from 2008 to 2015. Fractures were categorized as high- or low-energy fracture with high-energy fractures defined as those with lateral mass comminution (>50%) or secondary fracture lines into the pars interarticularis or vertebral body. Patients were treated in either a hard collar orthosis or halo vest and were followed for fracture union and stability. One hundred and twenty-five Type III odontoid fractures were identified with 51% classified as complex fractures. Thirty-three patients met the inclusion and exclusion criteria including 15 patients treated in a halo vest and 18 in a hard collar orthosis. Mean follow-up was 32 (±44) weeks. Seven patients demonstrated progressive displacement of either 2 mm of translation or 5° of angulation and underwent delayed surgical stabilization. Two addit...Continue Reading

Citations

Mar 20, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Salvatore RussoKhai Lam

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