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Conservative Management of Odontoid Peg Fractures, long term follow up
Aheed Osman1, Nabil A Alageli2, D J Short3
1The Midlands Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, United Kingdom.
Objective:
The aim of the study was to look at the long-term effects of conservative management of odontoid peg fractures.
Methods:
We reviewed 48 consecutive patients with type II (32) and 16 type III, odontoid peg fractures. The clinical & radiological outcomes were assessed over an average period of follow up of 8 years. Union rate was determined and we discussed several factors that may affect it. Patients were treated conservatively with an average period of bed rest of 4 weeks followed by bracing for an average of 9 weeks.
Results:
Bony union was established in 25 of 32 (78%) type II fractures. Of 7 cases of no bony union 4 were stable probably with fibrous union. 3 remained unstable. In 13 of 16(83%) type III fractures bony union was established. 2 of the 3 with no bony union were considered stable.
Conclusion:
Osseous non-union was higher in patients with displacement of >5 mm, but there is no correlation between union and age, gender or angulation of the fracture in both types.
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