![]() The present study was approved by the local ethics commission in charge (Ethics Committee of the State Medical Association Rhineland-Palatinate, Mainz, Germany). Whereas the ventral screw osteosynthesis could only be applied in type A and type B fractures due to an increased risk for a ventral dislocation of the odontoid, the dorsal instrumentation, may be applicable in all fracture types according to Eysel and Roosen. 1C) that can be treated with dorsal instrumentation of C1 and C2. 1B) that can be treated like type A type C is a fracture line from ventrocaudal to dorsocranial (Fig. 1A) that can be treated with ventral screw osteosynthesis type B is a fracture line from ventrocranial to dorsocaudal (Fig. 1): type A is a horizontal fracture (Fig. Around 19 years later, type II odontoid fractures according to Anderson and D’Alonzo were subclassified by Eysel and Roosen for association with different treatment options (Fig. In 1974, Anderson and D’Alonzo established a classification system for odontoid fractures according to fracture morphology : type I fractures affect the tip of the odontoid, type II fractures affect the base of the odontoid, and in type III fractures, the corpus of the axis is affected. The poor bone quality of the geriatric population together with pre-existing conditions such as osteopenia and osteoporosis are one of the main reasons for occurrence of this fracture. In contrast to odontoid fractures in young patients, these injuries in the geriatric population are mainly caused by minor trauma and falls at home. In these geriatric patients, odontoid fractures are the most common, comprising more than 50% of fractures of the cervical spine. Geriatric patients, having a worse general condition and a corresponding increased need for extensive care, can be identified by using the seniors at risk (ISAR) score upon admission to the hospital. Dorsal instrumentation may offer some advantages.ĭue to demographic changes, the number of geriatric trauma patients is constantly increasing. Geriatric patients with odontoid fracture require individual treatment planning. There was no significant difference in complications. The patients with dorsal instrumentation were hospitalized significantly longer however, their duration at the ICU was shortest. The trabecular bone fracture healing rate was 78.6%. Other directions of motion were not significantly different. Patients with dorsal instrumentation had a better rotation. ResultsĪ total of 72 patients were included and 43 patients could be re-examined (range: 2.7 ± 2.1 months). Furthermore, demographic patient data, neurological status, length of stay at the hospital and at the intensive care unit (ICU) as well as the duration of surgery and occurring complications were analyzed. At a follow-up examination, the range of motion and the trabecular bone fracture healing rate were evaluated. Three groups were compared: conservative treatment, surgical therapy with ventral screw osteosynthesis or dorsal instrumentation. Included were patients with the following criteria: age ≥ 65 years, identification of seniors at risk (ISAR score ≥ 2), and odontoid fracture type A/B according to Eysel and Roosen. ![]() The aim of this study was to compare the treatment options for geriatric odontoid fractures. Different treatment options are discussed for geriatric odontoid fracture. ![]()
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