Odontoid Peg Fractures - Andrew Bucknill 5/10/2002

 

Brief

Anderson LD, D’Alonzo RT

JBJS

1974

Title

Fractures of the Odontoid Process of the Axis

Authors

Anderson LD, D’Alonzo RT

Reference

JBJS 1974, 56A, 1663 - 1674

Summary

49 Fractures. Classified into Avulsion, Body and Basilar types. 22/12 FU. Type 2 most prone to non-union and surgery.

Critique

Critisised for not accounting for displacement.

 

 

 

 

Brief

Hanson PB, et al

Spine

1991

Title

Anatomic and Biomechanical Assessment of Transarticular Screw Fixation for Atlantoaxial Instability

Authors

Hanson PB, Montesano PX, Sharkey NA, Rauschning W

Reference

Spine 1991 16 (10) 1141 - 1145

Summary

Cadaveric biomechanical comparison of stiffness of Gallie wiring and Magerl Screws for C1-2 fusion. Screws stiffer.

Critique

Low numbers (5) and no clinical correlation

 

 

 

 

Brief

Johnson RM, Hart DL, et al

JBJS

1977

Title

Cervical Orthoses

Authors

Johnson RM, Hart DL, Simmons EF, Ramsby GR, Haven W, Southwick WO

Reference

JBJS 1977, 59A, 332 - 339

Summary

Comparison of various conventional collars and Halo for stiffness in normal subjects. HALO 75% restriction and collars 45% of Flexion/Extension at C1-2. Conventional collars better at middle and lower parts of cervical spine.

Critique

 

 

 

 

 

Brief

Clark CR, White AA

JBJS

1985

Title

Fractures of the Dens

Authors

Clark CR, White AA

Reference

JBJS 1985, 67A, 1340 - 1348

Summary

Multicenter prospective study of 96 patients. HALO successful in 68% of type 2 #’s but fusion successful in 96%.

Critique

Many variables – centres, surgeons etc. Numbers not large considering.

 

Classification:

Anderson & D’Alonzo

Treatment according to Rockwood & Green:

Type 1:    Rare and need Collar only

Type 2:    Displaced:        Odontoid single screw

                                       C1-2 fusion with Magerl screws or Brooks wiring

               Un-displaced:   Halo

Type 3:    Undisplaced:    Collar

               Displaced:        Halo



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