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[Clinical analysis of surgical treatment of odontoid fracture]
Ji-wei Tian1, Zhen Wang, Lei Wang
1Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated First Peoples' Hospital, Shanghai 201620, China. tjw609@163.com
Objective:
To evaluate the therapies and clinical outcome for different types of odontoid process fracture.
Methods:
Twenty-one patients with odontoid process fracture were treated with different therapies for different Anderson-D'Alonzo classifications: three cases of type I were treated by traction of occipital-jaw band and fixed with head-neck-chest plaster at 6 weeks; thirteen cases of type II were treated by cannulated screws following skull traction and reduction; and for the cases of type III, one was fixed with screw when the fracture was reduced by skull traction, and four with atlantoaxial pedicle screw.
Results:
All cases were followed up for a mean of 9 months (range: 3 - 48). All cases achieved bony union. No post-operative complication was found.
Conclusion:
Odontoid process fracture should be treated according to different types. Conservative treatment for type I fracture and cannulated screws for type II and low type III fracture can obtain a satisfactory outcome. Atlantoaxial pedicle screw should be chosen if the superficial type III fracture is not suitable for cannulated screw.
