Odontoid fracture: Difference between revisions

Revision as of 02:01, 6 January 2016

Also known as dens fracture
Only stable if fracture confined to avulsion of the tip (superior to transverse ligament)^[1]
Bimodal distribution
- Young - blunt trauma to head, flexion/extension injury
- Elderly - fall, with higher morbidity/mortality

Vertebral anatomy.

Numbering order of vertebrae.

Imaging
- Xray: AP, lateral, open-mouth odontoid view of cervical spine
- CT for further assessment if fracture identified

Type I: Oblique avulsion fracture of tip of odontoid; alar ligament avulsion
- Stable
- atlanto-occipital instability should be ruled out with flexion and extension films
Type II: Fracture at base of odontoid process where it attaches to C2; Fracture through waist
- Unstable
- high nonunion rate due to interruption of blood supply
  - Young: Halo if no risk factors for nonunion, Surgery if risk factors for nonunion
  - Elderly: Collar if not surgical candidates, Surgery if surgical candidates
Type III: Extension of the fracture through upper portion of body of C2
- Unstable

Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization
Consult ortho/neurosurgery/trauma

↑ Clark, J., Abdullah, K. and Mroz, T. (2011) Biomechanics of the Craniovertebral Junction. Edited by Vaclav Klika

Authors:

@@ Line 2: / Line 2: @@
 *Also known as dens fracture
 *Only stable if fracture confined to avulsion of the tip (superior to transverse ligament)<ref>Clark, J., Abdullah, K. and Mroz, T. (2011) Biomechanics of the Craniovertebral Junction. Edited by Vaclav Klika</ref>
+*Bimodal distribution
+**Young - blunt trauma to head, flexion/extension injury
+**Elderly - fall, with higher morbidity/mortality
 ==Clinical Features==