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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Related Experiment Video

Updated: Aug 11, 2025

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Traumatic Posterior Atlantoaxial Dislocation With an Associated Fracture: A Systematic Review.

Ahmad Essa1,2, Salah Khatib1,2, Eran Beit Ner1,2

  • 1Department of Orthopedics, Shamir (Assaf Harofeh) Medical Center.

Clinical Spine Surgery
|February 7, 2023
PubMed
Summary

Traumatic posterior atlantoaxial dislocation with fracture (TPAD) most commonly involves Anderson and D'alonzo type II odontoid fractures, predominantly in males. Surgical intervention, particularly posterior C1-C2 fusion, yields favorable outcomes.

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Trauma Surgery

Background:

  • Traumatic posterior atlantoaxial dislocation with fracture (TPAD) is a rare but severe spinal injury.
  • Understanding its characteristics is crucial due to high risks of spinal cord compression and neurological deficits.

Approach:

  • Systematic review of English-written studies on TPAD with fractures.
  • Literature search conducted via the Pubmed database following PRISMA guidelines.

Key Points:

  • 28 patients from 22 studies (case series/reports) between 1924-2021.
  • Predominantly affected males (83%), median age 51.5 years.
  • Anderson and D'alonzo type II odontoid fracture (78%) was most common; 52% had intact neurological exams at presentation.
  • CT scans (96%) were primary diagnostic tools.
  • Two-stage management: initial traction (54%) followed by surgery (93%), with posterior C1-C2 fusion favored (82%).

Conclusions:

  • TPAD with fracture is strongly associated with type II odontoid fractures and male gender.
  • CT imaging is generally sufficient for diagnosis.
  • Surgical treatment, especially posterior C1-C2 fusion, is the mainstay and shows positive results.