Type D fractures of the odontoid process

• Published in: European journal of orthopaedic surgery & traumatology 2010-12, Vol.20 (8), p.597-601
• Main Authors: Korres, Demetrios S., Mavrogenis, Andreas F., Gratsias, Petros, Posantzis, Marcos J., Giannakopoulos, Evangelos Ag, Efstathopoulos, Nikolaos E.
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Article; Range of motion; Surgical Orthopedics; Traumatic Surgery
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-010-0636-2

Type D fractures of the odontoid process are rare and usually occur in the elderly. The mechanism of fracture is unclear. Non-operative treatment is indicated provided that adequate immobilization using skull traction followed by either a collar or a halo vest can be achieved. The prognosis is usually favorable for this type of fractures. We present six patients with complex (type D) fractures of the odontoid process admitted and treated at our institution since 1970. There were five men and one woman with a mean age of 57.7 years (range, 16–81 years). Although there were concomitant injuries, no neurological deficits due to the odontoid process fracture was detected. All patients were treated non-operatively using skull traction or a halo vest for 8–12 weeks. One patient deceased 2 days after the injury. At the latest examination, all the remaining five patients had complete union of the odontoid process fracture; three of them had excellent range of motion and two had painful or restricted range of motion of the upper cervical spine.