Print version ISSN 1808-1851
HUBNER, André Rafael; SPINELLI, Leandro de Freitas and KLAUS, Alex Magadiel. Decision making for the treatment of odontoid fractures. Coluna/Columna [online]. 2010, vol.9, n.1, pp. 43-48. ISSN 1808-1851. http://dx.doi.org/10.1590/S1808-18512010000100009.
OBJECTIVE: this paper evaluates and determines the criteria that may guide the treatment of odontoid fractures. METHODS: a retrospective and comparative study of conservative versus surgical treatment for odontoid was carried out with 24 patients who suffered odontoid fracture due to trauma. RESULTS: seventeen males (70.8%) and seven females (29.2%) ranging from 12 to 80 years old (mean 39 years old) and followed-up from 12 to 110 months were selected for the analysis. None type I fracture was found, 17 patients had type II fractures (70.8%) and seven type III fractures (29.2%), all classified according to Anderson and D'Alonzo criterion. Decision making for surgical or conservative treatment occurred depending on reduction and instability criteria. Surgical treatment was carried out by Southwick-Robinson technique, by one cannulated screw for assuring odontoid fixation. Conservative treatment was performed with halo-vest or Philadelphia cervical collar. Independently on the fracture type, the consolidation occurred within three months for patients treated surgically and within five months for patients treated conservatively. CONCLUSIONS: the surgical treatment could determine a faster consolidation, but the conservative option must be observed since reduction and stability are obtained.
Keywords : Fracture fixation, internal [methods]; Odontoid process [surgery]; Odontoid process [therapy].