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Odontoid fractures, systemic disease and conservative care
The Australian and New Zealand Journal of Surgery
|June 1, 1984
Summary
This study reviews odontoid process fractures in elderly patients, identifying complicating factors like osteoporosis. Early mobilization with orthotic devices and monitoring is key to preventing complications from these cervical fractures.
Area of Science:
- Orthopedics
- Traumatology
- Geriatric Medicine
Background:
- Fractures of the odontoid process of the axis are significant cervical spine injuries.
- These fractures can occur in elderly patients, often with minimal trauma.
- Complicating factors include alcoholism, head injury sequelae, osteoarthritis, cervical spondylosis, rheumatoid arthritis, and osteoporosis.
Purpose of the Study:
- To review patients with odontoid process fractures admitted to a spinal unit.
- To identify potential complicating factors in the management of these fractures.
- To evaluate the effectiveness of early mobilization in preventing complications.
Main Methods:
- Retrospective review of patients diagnosed with odontoid process fractures.
- Inclusion criteria: patients admitted to Prince Henry Hospital Spinal Unit between January 1982 and January 1983.
- Data collected included patient demographics, associated conditions, and management strategies.
Main Results:
- Nine patients with odontoid process fractures were identified, representing 20% of new cervical fractures.
- The mean age of patients was 64.5 years.
- Osteoporosis was suggested in elderly patients with minimal trauma, indicating a potential complicating factor.
Conclusions:
- Odontoid fractures in the elderly, especially with minimal trauma, may indicate underlying osteoporosis.
- Early mobilization using a custom-moulded orthosis is recommended.
- Frequent radiological monitoring is crucial to prevent complications associated with prolonged bed rest.