Temporary Internal Bracing for Pediatric Odontoid Synchondrosis Fracture

Area of Science:

• Pediatric Orthopedics
• Pediatric Neurosurgery
• Spine Surgery

Background:

• Children's unique anatomy predisposes them to upper cervical spine injuries.
• Odontoid synchondrosis fractures are common pediatric cervical spine injuries.
• Operative management is often required for displaced fractures unsuitable for conservative treatment.

Observation:

• A 3-year-old female sustained a displaced odontoid synchondrosis fracture after a motor vehicle collision.
• Closed reduction was insufficient to adequately align the fracture.
• The patient underwent a novel operative approach involving temporary C1-2 posterior instrumentation without arthrodesis.

Findings:

• The novel technique successfully managed the displaced odontoid synchondrosis fracture.
• Temporary internal bracing preserved maximal atlantoaxial range of motion (ROM).
• Excellent functional results were achieved without permanent ROM limitation.

Implications:

• This approach offers a potential alternative to permanent C1-2 fusion for pediatric odontoid fractures.
• Preserving atlantoaxial ROM may improve long-term outcomes in pediatric patients.
• Further research can validate this technique for broader clinical application.