Retrospective review of acute axis fractures treated at a tertiary referral center.
To determine the optimal treatment of axis fractures based on 340 cases from a single institution. of Background Data.
Axis fractures account for almost 20% of acute cervical spine fractures.
However, their management and the clinical criteria predictive of nonoperative failure remain unclear.
Admission imaging studies and clinical variables were obtained for 340 consecutive axis fracture patients.
Fractures were classified as odontoid Type I, II, or III with dens displacement on admission roentgenograms ; hangman's fractures of Francis grade and Effendi type : and miscellaneous fractures.
Treatment methods were documented, and outcomes were based on dynamic lateral roentgenograms, clinical examination, or telephone interviews at last follow-up.
Follow-up data were available in 92% of cases.
Type II odontoid fractures comprised 35% of all axis fractures, were the most difficult to treat, and had the highest nonunion rate (28.4%). Odontoid displacement of 6 mm or more was associated with Type II nonunion (chi-square : 33.74, P<0.0001).
Patients underwent surgical fusion if fracture alignment could not be maintained by an external orthosis, or if they had odontoid fractures with transverse ligament disruption.
Type II odontoid fractures with dens displacement of at least 6 mm, or hangman's fractures of severe Francis grade or Effendi type. (...)
Mots-clés Pascal : Fracture, Axis, Aigu, Classification par stade, Indication, Traitement orthopédique, Pronostic, Homme, Epidémiologie, Apophyse odontoïde, Rachis cervical, Système ostéoarticulaire pathologie, Traumatisme, Rachis pathologie
Mots-clés Pascal anglais : Fracture, Axis(vertebrata), Acute, Stage classification, Indication, Orthopedic treatment, Prognosis, Human, Epidemiology, Odontoid process of axis, Cervical spine, Diseases of the osteoarticular system, Trauma, Spine disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0455517
Code Inist : 002B16H. Création : 03/02/1998.