Posterior fusion for odontoid fracture in an infant--case report

A 2-year-3-month-old girl presented with a rare displaced odontoid fracture. She was managed nonoperatively by manipulation followed by 3-month extracorporeal fixation with a halo brace. However, lateral radiography revealed recurrent dislocation at the base of the odontoid process. Magnetic resonance imaging demonstrated a "synchondrotic slip." She therefore underwent posterior wiring with iliac bone grafting to prevent pseudoarthrosis. The odontoid process had fused to the axis at 4 months postoperatively. Surgical management should be considered as a treatment method for pediatric odontoid fracture because of the difficulties in maintaining long-term immobilization and confirming the union.