5. C2-fractures: part II. Failure to maintain reduction in halo vest or inability to tolerate halo vest immobilization is another indication. Eur Spine J. J Spinal Disord Tech. Management of acute odontoid fractures: operative techniques and complication avoidance. Usually, these fractures are secondary to motor vehicle accidents or falls. Type III odontoid fractures extend into the cancellous portion of the C2 vertebral body. 33 (3):255-8. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. 2008;21 (7): 524-6. Chronic hypertrophic malunion of C2 Fracture causing cervical quadriparesis; Case report and focused literature review. Treatment may include closed reduction prior to stabilization in an external orthosis. Pathology. Fractures of the C2 pedicles (also known as traumatic spondylolisthesis or hangman’s fractures) are often classified based on the mechanism of injury,6,7 where flexion (type III) and flexion-distraction (type IIa) are often unstable and require surgical fixation, especially type IIa injuries with greater than 4 mm distraction and/or greater than 11 degrees of angulation. Direct repair of the fracture will not restore C1-C2 stability in the setting of an incompetent ligament. Infant Brachial Plexus Injuries: When to Refer Immediately and When to Wait, The 5 Most Denied Prior Authorization Requests and How to Prevent These Denials, 'These Are Not Things I'm Getting Paid For', A Matched-Cohort Study Comparing Outpatient Total Knee Arthroplasty in An Ambulatory Surgery Center With Inpatient Total Knee Arthroplasty in a Hospital, Arthroscopic Partial Meniscectomy Tied to Radiographic Knee Osteoarthritis, Experts Unravel the 'Mysteries of Wrist Motion', Pandemic Hampers Reopening of Joint Replacement Gold Mine, Orthopedic Problems in Children Can Be the First Indication of Acute Lymphoblastic Leukemia, Chemoradiotherapy Raises Risk of Thoracic Vertebral Fracture. In addition, the transverse ligament must be carefully assessed for injury, because injury to this ligament is a contraindication to anterior odontoid screw fixation. Odontoid = A peg-like part of the second bone in the neck Fracture = A break in a boneA type II odontoid fracture is a break that occurs through a specific part of C2, the second bone in the neck.Bones of the spine are called vertebrae. 2006;88 (1): 106-12. Other types of neck fractures include, but are not limited to clay shoveler's fracture and simple wedge fracture. Odontoid fractures can be caused by both extension and flexion forces. /viewarticle/937320 Cho DC, Sung JK. Severely debilitated patients, on the other hand, can be treated with a cervical collar until comfortable, with the understanding that a successful fusion may not occur. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Tested Concept, (OBQ08.78) account for 10-15% of all cervical fractures, most common cervical spine fractures in the elderly, occur in bimodal fashion in elderly and young patients, associated with increased morbidity and mortality compared to younger patients with this injury, result from blunt trauma to head leading to cervical hyperflexion or hyperextension, caused by direct impact from the anterior arch of atlas during hyperextension. Spine (Phila Pa 1976). Odontoid fractures are relatively common fractures of the C2 vertebral body (axis) that can be seen in low energy falls in eldery patients and high energy traumatic injuries in younger patients. Immobilization is associated with a 68% bony union rate, and factors implicated in lower fusion rates include increased age, greater displacement of the fracture plane at final reduction, and a history of smoking. eCollection 2020 Aug. Rizkalla JM, Hotchkiss W, Clavenna A, Dossett A, Syed IY. Chapman J, Smith JS, Kopjar B, Vaccaro AR, Arnold P, Shaffrey CI, et al. For unclear reasons he did not seek medical attention. Anderson and D'Alonzo classified odontoid fractures based on the anatomic location of the fracture (see the image below). 2007 Jul.   Type 1 fractures occur at the tip of the odontoid and are typically treated nonoperatively. Please confirm that you would like to log out of Medscape. Figure 1: Anderson and D'Alzonzo classification, Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, anterior subluxation of the cervical spine, describes level of fracture line (i.e.

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