Odontoid Fractures: A Standard Review of Current Concepts and Treatment Recommendations

Odontoid fractures represent the most common fractures involving C2 and the most common cervical spine fractures in patients older than 65 years. Despite their increasing frequency, optimal management of these injuries remain a subject to debate. Although types I and III injuries have relatively goo...

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Bibliographic Details
Published inJournal of the American Academy of Orthopaedic Surgeons Vol. 30; no. 6; p. e561
Main Authors Nourbakhsh, Ali, Hanson, Zachary C
Format Journal Article
LanguageEnglish
Published United States 15.03.2022
Subjects
Aged
Cervical Vertebrae - injuries
Fracture Fixation
Fractures, Bone
Humans
Odontoid Process - injuries
Spinal Fractures - surgery
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Summary:Odontoid fractures represent the most common fractures involving C2 and the most common cervical spine fractures in patients older than 65 years. Despite their increasing frequency, optimal management of these injuries remain a subject to debate. Although types I and III injuries have relatively good healing potential with nonsurgical treatment, type II fractures carry a higher risk for nonunion. In particular, elderly patients are at risk for nonunion or fibrous malunion after nonsurgical treatment; however, increased medical comorbidities and poor bone quality also increase the risks of surgery in this cohort. The high morbidity and mortality associated with these injuries has made it an area of particular interest among spine surgeons. The purpose of this review was to summarize the pathophysiology, evaluation, and diagnosis of these injuries and to review controversies in management and considerations for treatment based on the most recent available literature.
ISSN:1940-5480
DOI:10.5435/JAAOS-D-21-00165