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Related Experiment Videos

Vertically unstable type III odontoid fractures: case report.

Andrew Jea1, Claudio Tatsui, Hamad Farhat

  • 1Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA.

Neurosurgery
|April 1, 2006
PubMed
Summary

A rare Type III odontoid fracture subtype can cause severe neurological deficits like quadriplegia. Prompt surgical intervention is crucial for these unstable fractures to prevent devastating outcomes.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Trauma Surgery

Background:

  • Type III odontoid fractures are typically treated with external orthoses.
  • A rare subtype presents with instability comparable to atlanto-occipital dislocations.
  • Failure to recognize and treat this subtype aggressively can lead to severe neurological injury.

Observation:

  • A 73-year-old woman presented with a vertically distracted Type III odontoid fracture.
  • She exhibited quadriparesis and brainstem deficits.
  • Initial management included a rigid collar and kinematic bed, avoiding traction.

Findings:

  • Surgical intervention involved C1-C2 fixation with a screw-rod construct and iliac crest bone graft.
  • This approach was undertaken once the patient was systemically stable.

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  • The patient's condition required urgent and aggressive management.

    • Implications:

    • Delayed diagnosis of this fracture subtype carries a high risk of mortality and severe morbidity.
    • Potential consequences include quadriparesis, lower brainstem dysfunction, and ventilator dependence.
    • Maintaining a high index of suspicion for this unusual fracture pattern is essential for clinicians.