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. Treatment depends on the location of the fracture within the C2 vertebrae defined by the Anderson and D'Alonzo classification system and the patient's risk factors for nonunion (failed bone healing). odontoid fracture Orthopedics A fracture caused by 'sudden forward and backward movement of the head with respect to the trunk', with a shearing of the dens from the body of C2, with forward movement by the transverse ligament, with backward movement by the anterior arch of C1; flexion is the most common mechanism of injury; extension injuries result in posterior displacement of the dens.
A 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. The bone involved in odontoid fracture is the second vertebra, C2, high up in the neck. The joint between C2 and the vertebra above, C1, has an outstanding range of motion.
This is the joint that allows the head to rotate from side to side, bend forward and bend backward. One of the unique features of this joint is a peg of bone called the odontoid process sometimes called the dens. It is about the size of the tip of a pinky finger. The odontoid process sticks up from the front of C2 what is an odontoid fracture fits into a groove in C1.
In an odontoid fracture, that peg of bone is broken. In a Type I odontoid fracture, just the tip of the bone is broken. In a Type II fracture, the most common type, the peg is broken at its base.
In a Type III fracture, the bone is broken below the base of the peg. Some fractures are considered stable, and some are unstable. In a stable fracture, the bone does not move out of its normal anatomical position and how to run print spooler service. In an unstable fracture, the bone is more likely to move out of its normal position and alignment.
Type II fractures are considered the least stable of the odontoid fractures. This makes them the most likely to require surgery. A fracture that compresses the spinal cord may injure its delicate fibers. This type of injury to the spinal cord is called myelopathy, and it may lead to neurological symptoms like pain or numbness in the back, legs, and arms. Type II odontoid fractures occur when the cervical spine is hyperflexed bent severely backward or hyperextended bent severely forward.
Hyperflexion and hyperextension can be caused by trauma such as a fall or whiplash from a motor vehicle accident. Age plays a big role in the incidence of odontoid fractures—they are the most common type of cervical spine fractures in patients older than This is probably due to the increased risk of falls in the elderly, as well as the greater incidence of osteoporosis a condition of weak and brittle bones.
Type II odontoid fractures can also occur in younger patients, most commonly as the result of trauma from a motor vehicle accident. The doctor will take a complete medical history and perform a complete physical examination.
If a T ype II Odontoid Fracture is suspected, the doctor may order the following diagnostic procedures:.
Treatment options for type II odontoid fractures can be nonsurgical or surgical. Nonsurgical measures include immobilization, prevent or restrict movement, in a cervical collar or halo vest. One surgical option is a procedure called anterior screw fixation. During this procedure, the surgeon approaches the vertebra from the front of the neck an anterior approach and places an internal fixation, like screws, to hold the vertebrae in place while the bone heals.
Another option is a similar procedure performed from the back of the neck a posterior approach. During this procedure, the surgeon fuses C1 and C2, the first and second how to host a minecraft server without port forwarding. The treatment of stable odontoid fractures remains controversial. The surgeon will determine the best treatment for each patient and each situation. Paul C. McCormickPeter D.
AngevineChristopher E. Mandigoand Patrick C. Reid are experts in treating type II odontoid fractures. Any one of them can also offer you a second opinion. Search for:. McCormick Dr. Peter D. Angevine Dr. Christopher E. Mandigo Dr. Simon Morr Dr. Donald O. Quest Dr. Patrick C. Reid Dr. Neil A. Type II Odontoid Fracture. Symptoms A fracture that compresses the spinal cord may injure its delicate fibers.
Causes and Risk Factors Type II odontoid fractures occur when the cervical spine is hyperflexed bent severely backward or hyperextended bent severely forward. Tests and Diagnosis The doctor will take a complete medical history and perform a complete physical examination. If a T ype II Odontoid Fracture is suspected, the doctor may order the following diagnostic procedures: X-rays — test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.
Magnetic resonance imaging MRI — a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
Computed tomography scan CT scan — a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs.
CT scans are more detailed than general X-rays. Nuclear bone scan — a diagnostic procedure in which a radioactive substance is injected into the body to measure activity in the bones. The amount of radiation is small—less than the radiation in half of one CT scan.
This scan helps identify damaged bones. Treatments What is an odontoid fracture options for type II odontoid fractures can be nonsurgical or surgical.
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Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. Pathology. The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. Classification. There are two classification systems 5,6. Anderson and D'Alonzo. Odontoid fractures can be caused by both extension and flexion forces. When a flexion/shear force is the cause of an odontoid fracture, there is anterior displacement of C1 on C2, although this may also be seen as sequelae of an extension injury. The treatment of . The odontoid process, also known as the dens, is an upward projectile of bone that arises from the front part of the center of the axis vertebra. (The axis is the 2nd highest spinal bone.) The atlas is the first bone of your neck; it sits on top of the axis. (The skull sits on top of the atlas.) The dens projects into a central space in the atlas and this is how the bones of the atlantoaxial (atlanto relates to atlas, and axial Estimated Reading Time: 5 mins.
Odontoid process fracture , also known as a peg or dens fracture , occurs where there is a fracture through the odontoid process of C2. The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5.
Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait. Unable to process the form. Check for errors and try again. Thank you for updating your details. Log In. Sign Up. Become a Gold Supporter and see no ads. Log in Sign up. Articles Cases Courses Quiz. About Blog Go ad-free. Pathology The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. Classification There are two classification systems 5,6 Anderson and D'Alonzo most commonly used describes level of fracture line i.
Quiz questions. The utility of MRI in the evaluation of odontoid fractures. J Spinal Disord Tech. Odontoid fractures: update on management. J Am Acad Orthop Surg. Pubmed citation 3. Vertically unstable type III odontoid fractures: case report. CD - Pubmed citation 4. Reliability and reproducibility of dens fracture classification with use of plain radiography and reformatted computer-aided tomography. J Bone Joint Surg Am. Type II odontoid fractures in the elderly: an evidence-based narrative review of management.
Eur Spine J. Edit article Share article View revision history Report problem with Article. URL of Article. Article information. Systems: Musculoskeletal , Spine , Trauma. Section: Classifications. Tags: trauma , trauma , emergencymedicine , orthopaedics , neurosurgery. Synonyms or Alternate Spellings: Odontoid process fracture Dens fracture Odontoid peg fracture Odontoid fractures Odontoid peg fractures Dens fractures Odontoid process fractures. Case 1 Case 1. Case 2 Case 2.
Case 5 Case 5. Os odontoideum Os odontoideum. Persistant ossiculum terminale Persistant ossiculum terminale. Loading more images Close Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Loading Stack - 0 images remaining.
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