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Two cases of odontoid fracture in preschool children
Toru Uchiyama1, Youichi Kawaji, Koji Moriya
1Department of Orthopedic Surgery, Tachikawa General Hospital, Nagaoka, Japan. toru.uchiyama@nifty.com
Insights
Minerva casts effectively treat pediatric odontoid fractures, offering a safe alternative to halo vests for young children. This method ensures bone union and minimal neurological deficits, allowing children to return to daily activities.
Area of Science:
- Orthopedics
- Pediatric Traumatology
- Neurosurgery
Background:
- Cervical immobilization is crucial for spinal injuries.
- Halo vests are standard but carry risks in children due to skull and bone immaturity.
- Odontoid fractures are serious injuries requiring prompt management.
Observation:
- Two preschool-aged children with displaced odontoid fractures from motor vehicle accidents were treated.
- Immediate reduction and immobilization were achieved using a Minerva cast.
- A soft collar was applied subsequently.
Findings:
- Uneventful bone union occurred in both cases by the 1-year follow-up.
- Children experienced minimal to no neurological deficits.
- Minerva cast immobilization proved effective for displaced odontoid fractures.
Implications:
- The Minerva cast is a viable, cost-effective option for pediatric cervical immobilization.
- Immediate reduction and casting are recommended for displaced odontoid fractures in young children.
- This approach can prevent complications associated with halo vests in pediatric patients.
Abstract:
Halo application is a standard method for cervical immobilization. However, complications may occur in children because of their thin skull and immature bone. The authors report two cases of odontoid fracture in preschool children treated with a Minerva cast. Two 4-year-old children sustained displaced odontoid fractures in motor vehicle accidents. The fractures were immediately reduced and immobilized using a Minerva cast, followed by the application of a soft collar. By the 1-year follow-up, uneventful bone union had occurred, and the children were able to attend preschool with minimal or no neurologic deficits. The Minerva cast is a classic, inexpensive method of cervical immobilization and is still useful for this kind of fracture. Immediate reduction and immobilization with a Minerva cast is a viable option for displaced odontoid fractures in preschool children.
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