[Dens fracture in elderly patients and surgical management]

The problems of surgical therapy in seven patients aged over 70 years are discussed. Clinical and radiological findings as well as operative treatment (anterior transaxial screw osteosynthesis or posterior atlanto-axial arthrodesis) are analysed in detail. Five out of 7 patients treated in this way could be early mobilised. Two patients died on multiorgan failure after an initial uneventful postoperative course (28.6% mortality rate). A stable osteosynthesis was obtained in all cases; a complete bony fusion as could be radiologically demonstrated, occurred in four out of the five survivors. We feel that despite this relatively high mortality rate surgical treatment provides better recovery chances and a higher quality of life to such patients.