Review of Management of Type-2 Odontoid Fracture in Elderly

• 作者: Jagodish Chandra Ghosh
• 来源期刊: 矫形学期刊(英文)
• 学科: 医学
• 关键词: ODONTOID FRACTURE Type-2 MANAGEMENT REVIEW
• 年，卷（期）: 2021,（1）
• 页码范围: 12-21
• 页数: 10页
• 分类号: R68

摘要

Odontoid fracture accounts for 15%<span> - 20% of all cervical spine injuries. Among the odontoid fracture, type-2 fracture </span><span>is</span><span> the most common variety. This injury is associated with a high incidence of morbidity, mortality and nonunion in </span><span>the </span><span>elderly irrespective of mode of treatment. Management of odontoid fracture cannot be standardized till to date and ideal treatment for type-2 odontoid fractures still ha</span><span>s</span><span> some controversial issues. Objective of this review is to find </span><span>a </span><span>controversial aspect of management along with opinion to find out a standard guideline by searching the literature in Pubmed and Google scholar databases with key words</span><span>: </span><span>odontoid, fracture, type-2, management, nonoperative and operative management. Nonoperative treatment with halo vest is associated with very high rate of complication in elderly patient. When conservative treatment of this fractures is indicated that should be carried out with hard cervical collar or cervicothoracic orthosis. Current studies suggest that surgical management of odontoid fractures may offer a protective benefit but it is limited to patients younger than 75 years of age. Though surgical treatment has </span><span>a </span><span>better outcome</span><span>, it </span><span>is also limited by the co-mobidities and hazards of anesthesia and surgery in elderly patients. Conservative treatment of this fracture in </span><span>the </span><span>elderly should preferably be carried out with hard collar or avoiding halo vest. Surgical treatment is associated with little advantage but should be selected with proper attention to age, comorbidities, fracture geometry and it is better to individualize the treatment strategy.</span>