Pediatric axis fractures: early halo immobilization, management and outcome

Pediatric C-2 fractures have been managed with initial cranial skeletal tong traction or a period of bed rest for reduction and alignment followed by external and/or surgical stabilization. Thirteen children were managed with early halo orthosis to provide the initial reduction/alignment and to accomplish long-term stabilization. Eighty percent had fusion with the halo alone, and 20% went on to fuse after surgery. The average hospitalization for isolated C-2 injury was 10.6 days. Minor complications occurred in 46% of the patients. The literature is reviewed as to the management and outcome of pediatric axis fractures.