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Anterior screw fixation of odontoid fractures
Background:
Anterior screw fixation is the best treatment for odontoid fractures when the fracture line is horizontal or oblique downward and backward, as it preserves atlantoaxial mobility, especially axial rotation. Some details regarding patient positioning and operative technique need to be stressed to obtain the best results and avoid complications.
Methods:
Between 1989 and 1997, we treated 17 cases of odontoid fracture by anterior screw fixation. Only two patients presented with motor neurologic deficit. Fracture line was horizontal in 3 cases and oblique downward and backward in 14 cases.
Results:
Adequate reduction and fixation was obtained in all cases except one, where posterior displacement of the screw occurred without neurologic complications. Functional result was satisfactory in all cases except two, where we noted significant limitation of cervical rotation.
Conclusion:
Successful anterior screw fixation gives the best anatomical and functional results for odontoid fractures. Correct installation is very important for operative success.