$odontoid fracture complications$

Prospective studies are needed to better elucidate management strategies for this difficult clinical problem. Type II odontoid fractures in the octogenarian population are associated with substantial morbidity and mortality, irrespective of management method. External immobilization is the treatment of choice for Type I and III there is still no wide consensus about the best management of Type II fractures. The percentage of patients experiencing at least one significant complication was higher in the operative group than the nonoperative group (62% vs. Abstract Odontoid fractures constitute the most common cervical fractures in elderly. Acute in-hospital mortality rate was 15% in the nonsurgical group and 12.5% in the surgical group (P>0.05). The mean age was 85.5+/-3.5 years in the surgical and 87.3+/-4.7 years in the nonsurgical group (P>0.05) mean length of acute hospital stay was 11.2+/-8.5 days in the nonsurgical and 22.8+/-28.3 days in the surgical group (P0.5) mean fracture displacement was 4.1+/-3.5 mm in the nonsurgical and 3.9+/-3.4 mm in the surgical group (P>0.5). Eight patients were excluded because the medical record could not be located. Thirty-two patients received operative treatment (10 anterior and 22 posterior) and 40 patients received nonsurgical treatment. The charts were reviewed and mechanism of injury, comorbidities, date of injury, date of admission, date of discharge, radiology reports, discharge disposition, associated injuries, fracture management, type of surgical fixation (if any), and documented complications were abstracted. Eighty neurologically intact patients over age 80 were identified with isolated acute type II odontoid fractures. Patients with associated cervical spine fractures were excluded. The medical records of 223 consecutive C2 fractures from June 1985 to July 2006 over the age of 80 years were reviewed retrospectively. Few studies have examined the acute in-hospital outcomes of isolated type II odontoid fractures in the octogenarian population.

$odontoid fracture complications$

Results are based on the literature and on our own experience. Studies suggest acute in-hospital complication rates in type II odontoid fractures in the elderly exceed 50%. 6 Altmetric Metrics Abstract Objectives We carried out a retrospective cohort study to differentiate geriatric odontoid fractures into stable and unstable and correlated it with fracture fusion rates. Type II odontoid fractures are the most common cervical spine fracture in the elderly. To assess the presentation and acute complications of operatively and nonoperatively managed type II odontoid fractures in the octogenarian population. In the elderly population, the trauma can occur after lower energy impacts such as falls from a standing position. In younger patients, they are typically the result of high-energy trauma, which occurs as a result of a motor vehicle or diving accident. The high levels of morbidity and mortality associated with odontoid fractures should encourage all providers to pursue medical co-management and optimization of bone health following diagnosis.A retrospective cohort study of operative versus nonoperative treatment of isolated type II odontoid fractures in patients aged 80 years and more without neurologic deficit admitted to a level 1 spinal cord injury center between June 1985 and July 2006. Odontoid fractures occur as a result of trauma to the cervical spine. If operative management is chosen, a posterior approach is should be chosen when fracture- or patient-related factors make an anterior approach challenging. In a frail elderly patient, a fibrous nonunion with close follow-up is an acceptable outcome. However, the risks of surgery in an elderly population must be carefully considered on a case-by-case basis. Type II fractures with any additonal risk factors for nonunion (displacement, comminution, etc) should be considered for surgical management. We believe that type I and type III odontoid fractures can be managed in a collar in most cases. Due to the strategic location of the fracture, many patients succumb at the.

$odontoid fracture complications$

A type II odontoid fracture extends through the base of the dens. A treatment algorithm is presented based on the available literature. Odontoid fractures comprise 9-20 of all cervical spine fractures. A fracture of the odontoid process (dens) can create instability of the head on the spine. The merits of operative vs nonoperative management, fibrous union, and the choice of operative approach in elderly patients are discussed. We provide a review of the existing literature and discuss the classification and evaluation of odontoid fractures. Poor bone health and medical comorbidities contribute to increased surgical risk in this population however, nonoperative management is associated with a risk of nonunion or fibrous union. Despite their frequency, there is considerable ambiguity regarding optimal management strategies for these fractures in the elderly. Odontoid fractures are the most common fracture of the axis and the most common cervical spine fracture in patients over 65.

$odontoid fracture complications$

Odontoid fracture complications