$type 3 odontoid fracture$

$type 3 odontoid fracture$

Or demonstrate prevertebral soft tissue swelling ( Fig. 11). Lateral radiographs may appear normal in the case of undisplaced Type 2 or 3 fractures, 10).Ī high degree of suspicion for peg fractures is needed when reviewing imaging of the head and cervical spine.ĭisplaced odontoid peg fractures can be identified on lateral radiographs ( Fig. One should ensure careful examination in 3 orthogonal planes to exclude extension of the fracture into the posterior elements ( Fig. Īs they involve the body of the axis and have a relatively large surface area they are relatively stable and have a much lower risk of malunion ( Fig. Making it more unstable and definitely necessitating surgical stabilisation to prevent non-union ( Fig.

$type 3 odontoid fracture$

Īlso involves additional chip fracture fragments at the base of the dens, Hadley et al suggested a modification of the Anderson & D’Alonzo classification system with the inclusion of a subtype of type 2 odontoid process fractures (type 2A). The risk of non-union is directly related to the degree of displacement ( Fig. Probably due to disruption of blood supply to the peg [5, With a risk of atlantoaxial subluxation if not promptly immobilised ( Fig. Or an associated occipital condyle fracture. They may be unstable if there is bilateral alar ligament avulsion, They are thought to be avulsion fractures of the alar or apical ligaments and occur above the level of the transverse ligaments, Type 1 odontoid process fractures are rare and somewhat controversial.

$type 3 odontoid fracture$

Oblique fracture through upper part of the odontoid process caused by bony avulsion by alar ligamentsįracture at junction between the odontoid process and the body of the axisįracture that extends down into the cancellous bone of the body of the axis and is in reality a fracture of the body of C2 The fracture types may then be further classified as displaced or non-displaced. The classification system is summarised in Table 1 and Fig. They characterised odontoid peg fractures according the plane of the fracture. The Anderson and D’Alonzo classification system is the most widely used. Neurological injury is uncommon but due to the risk of atlantoaxial subluxation and proximity of the medulla oblongata, Odontoid fractures are the most common isolated cervical spine fracture in patients over the age of 70 years.

$type 3 odontoid fracture$

Such as road traffic collisions in young or middle-aged patients. For complex Type III fractures, we recommend initial conservative treatment, while maintaining close monitoring throughout patient recovery and fracture union.Odontoid peg fractures are thought to occur following extreme hyperextension or hyperflexion of the cervical spine. In the current study, 21% of patients were unsuccessfully treated nonoperatively with external immobilization and required surgery. Conclusions: Complex Type III odontoid fractures are distinctly different from low-energy injuries. No statistical advantage of halo vest versus hard collar orthosis was observed. Initial fracture displacement and angulation were not correlative with final outcome. Two additional patients required delayed surgery for nonunion and myelopathy. Seven patients demonstrated progressive displacement of either 2 mm of translation or 5° of angulation and underwent delayed surgical stabilization. Thirty-three patients met the inclusion and exclusion criteria including 15 patients treated in a halo vest and 18 in a hard collar orthosis. Results: One hundred and twenty-five Type III odontoid fractures were identified with 51% classified as complex fractures. Patients were treated in either a hard collar orthosis or halo vest and were followed for fracture union and stability. Fractures were categorized as high- or low-energy fracture with high-energy fractures defined as those with lateral mass comminution (>50%) or secondary fracture lines into the pars interarticularis or vertebral body. Materials and Methods: Acute Type III odontoid fractures were identified at a single institution from 2008 to 2015. We hypothesize that a subgroup of complex, Type III fractures caused by high-energy mechanisms are more likely to fail nonoperative treatment. Objective: Type III odontoid fractures are classically treated nonoperatively, yet, the current literature on Type III odontoid fractures includes fractures of multiple etiologies and fracture morphologies. Study Design: Retrospective cohort study.

$type 3 odontoid fracture$

Type 3 odontoid fracture