Related Experiment Videos
Fractures of the odontoid process
S Govender1, J F Maharaj, M R Haffajee
1King Edward VIII Hospital, Durban, South Africa.
The Journal of Bone and Joint Surgery. British Volume
|December 29, 2000
Summary
Non-operative treatment of odontoid process fractures showed 54% union for type II and all type III fractures united. Factors like age over 40 and displacement influence type II nonunion.
Area of Science:
- Orthopedic surgery
- Spine trauma research
- Fracture healing mechanisms
Background:
- Odontoid process fractures are common cervical spine injuries.
- Non-operative management is a frequent treatment approach.
- Understanding factors influencing union is crucial for patient outcomes.
Purpose of the Study:
- To evaluate non-operative treatment outcomes for odontoid process fractures.
- To identify predictors of nonunion in type II odontoid fractures.
- To investigate the vascularity of the odontoid process.
Main Methods:
- Retrospective analysis of 183 patients with odontoid process fractures (109 type II, 74 type III) treated non-operatively.
- Selective vertebral angiography in 18 patients to assess blood supply.
- Post-mortem analysis of 10 adult axis vertebrae to compare fracture surface areas.
Main Results:
- Achieved 54% union rate for type II odontoid fractures; all type III fractures united, with 16 experiencing delayed union.
- No correlation found between fracture union and clinical or radiological outcomes.
- Vertebral angiography indicated no disruption of blood supply to the odontoid process.
- Statistically significant difference in surface area between type II and type III fractures.
Conclusions:
- Non-operative treatment yields variable union rates for type II odontoid fractures.
- Age >40 years, anterior displacement >4mm, posterior displacement, and late presentation are associated with type II nonunion.
- Vascularity is likely not a limiting factor in odontoid process fracture healing.