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Management of Combined Atlas Fracture with Type II Odontoid Fracture: A Review of 21 Cases
- Source :
- Indian Journal of Orthopaedics, Indian Journal of Orthopaedics, Vol 53, Iss 4, Pp 518-524 (2019)
- Publication Year :
- 2019
-
Abstract
- Purpose: To evaluate the therapeutic effects of combined atlas fracture with type II (C1-type II) odontoid fractures and to outline a management strategy for it. Patients and Methods: Twenty three patients with C1-type II odontoid fractures were treated according to our management strategy. Nonoperative external immobilization in the form of cervical collar and halo vest was used in 13 patients with stable atlantoaxial joint. Surgical treatment was early performed in 10 patients whose fractures with traumatic transverse atlantal ligament disruption or atlantoaxial instability. The visual analog scale (VAS), neck disability index (NDI) scale, and American Spinal Injury Association (ASIA) scale at each stage of followup were then collected and compared. Results: Compared to pretreatment, the VAS score, NDI score, and ASIA scale were improved among both groups at followup evaluation after treatment. However, in the nonsurgical group, one patient (1/11) developed nonunion which required surgical treatment in later stage and one patient (1/13) with halo vest immobilization had happened pin site infection. Two patients of the surgical group (2/11) had appeared minor complications: occipital cervical pain in one case and cerebrospinal fluid leakage in one case. Two patients (2/23) were excluded from nonsurgical treatment group because their followup period was less than 12 months. Twenty one patients were followed up regularly with an average of 23.9 months (range 15–45 months). Conclusions: We outlined our concluding management principle for the treatment of C1-type II odontoid fractures based on the nature of C1 fracture and atlantoaxial stability. The treatment principle can obtain satisfactory results for the management of C1-type II odontoid fractures.
- Subjects :
- medicine.medical_specialty
Visual analogue scale
Nonunion
cervical spine
03 medical and health sciences
0302 clinical medicine
lcsh:Orthopedic surgery
Atlas (anatomy)
medicine
Orthopedics and Sports Medicine
Odontoid fracture
030222 orthopedics
odontoid
business.industry
Therapeutic effect
030229 sport sciences
medicine.disease
Surgery
lcsh:RD701-811
medicine.anatomical_structure
Atlantoaxial instability
fracture
Orthopedic surgery
pedicle screw fixation
Cervical collar
Original Article
Atlas
business
Subjects
Details
- ISSN :
- 00195413
- Volume :
- 53
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Indian journal of orthopaedics
- Accession number :
- edsair.doi.dedup.....dfd7bfe1aa48cf60d5db7c6f4d3cf70b