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Traumatic odontoid fracture - Proposal of a treatment algorithm
Syed Ali Mujtaba Rizvi1, Hege Linnerud1, Pål Andre Rønning1
1Department of Neurosurgery, Oslo University Hospital, Postboks 4956 Nydalen, Oslo 0424, Norway.
Clinical Neurology and Neurosurgery
|May 8, 2025
Summary
A new treatment algorithm for odontoid fractures (OFx) showed high compliance (97.2%) and favorable outcomes in elderly, vulnerable patients. This approach is recommended for OFx management.
Area of Science:
- Orthopedics
- Trauma Surgery
- Geriatric Medicine
Background:
- Current odontoid fracture (OFx) guidelines lack specificity regarding age, comorbidity, and frailty.
- This variability necessitates reevaluation of existing management strategies.
- A new treatment algorithm was implemented at Oslo University Hospital (OUH) in 2022.
Purpose of the Study:
- To assess departmental compliance with the new OFx treatment algorithm.
- To evaluate the clinical outcomes of patients managed under this new algorithm.
Main Methods:
- A population-based cohort study of traumatic OFx in Southeast Norway (2022-2023).
- Assessment of compliance with the OUH treatment algorithm.
- Collection of patient demographics, injury characteristics, treatment decisions, and outcomes (union rates, disability).
Main Results:
- 181 patients with OFx, median age 78 years; 92.3% from falls, 70% vulnerable.
- High treatment compliance rate of 97.2%.
- Favorable outcomes: 80.6% union rate, low pain/stiffness, 78% 6-month survival.
Conclusions:
- The new OFx management algorithm demonstrated high compliance (97%) and positive clinical outcomes.
- The algorithm is suitable for managing elderly and vulnerable OFx patients.
- Findings support the algorithm's adoption as an appropriate treatment approach for OFx.
