Recent Trend in Management of Odontoid Fracture

Abstract

Background and aim: Odontoid fractures are among the most common spinal injuries of the elderly. Moreover, in patients older than 79 years, odontoid fractures occur even more frequently than all other spinal injuries together. Odontoid fractures account for 5-15 % of all cervical spine injuries in skeletally mature individuals. Methods: This study aimed to review and describe lines of treatment of odontoid process fracture with special reference to the recent treatment modalities. This is a review article, The search was performed in MEDLINE, Embase, Pubmed and CINAHL Plus in the same date range with the following mediacl terms: "Odontoid; Fracture; spinal injuries including articles from 2000 to 2021, Excluded articles from review are those of language other than English. Results and conclusion: Traumatic atlantoaxial dislocation with isolated odontoid fracture often encountered in clinical practice. Most of them reduce on extension, barring posterior dislocation. Skeletal traction helps, if they fail to reduce on extension. However, few patients, especially those presenting late, fail to reduce, despite traction. Previously, such patients with irreducible Traumatic atlantoaxial dislocation were managed with transoral odontoidectomy and posterior fusion. In the recent past, direct posterior reduction and fusion by intraoperative manipulation of the joints has been attempted successfully in a few cases of irreducible Traumatic atlantoaxial dislocation. Such a procedure is of advantage as it circumvents the transoral surgery. Non operative treatment include. Hard cervical orthosis for 6-12 weeks. halo vest immobilization for 6-12 weeks. Operative options include posterior C1-C2 fusion, Anterior odontoid osteosynthesis and transoral odontoidectomy.

Comparative study on fixation of Jones fracture using cannulated screws vs tension band

“…The patient was placed in a lateral or spinal Technique: In each case, a tourniquet was applied while the patient was supine and guided by an image intensifier. Two 1.6 or 1.8 mm Kwires were drilled into the medullary canal beginning at the base and extending across the fracture line fig (5). This was done after making the incision.…”