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Fresh Fracture of the Odontoid Process Treated with Direct Screw Fixation; A case report Takeshi HASEGAWA 1 , Yoshitaka HAMADA 2 , Tadao MIYAMORI 1 , Kiyotoshi YAMANO 1 1Department of Neurosurgery, Toyama Municipal Hospital 2Department of Neurosurgery, Kurobe Municipal Hospital Keyword: Odontoid fracture , Screw fixation , Anterior approach , Nonunion , Spinal injury pp.887-891
Published Date 1992/8/10
DOI https://doi.org/10.11477/mf.1436900509
  • Abstract
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A case of a fresh type II fracture (Anderson & D'Alonzo) of the odontoid process treated with direct screw fixation is reported.

A 52-year-old man complained of severe neck pain following a hit on his forehead incurred in a falling accident. Neurological examination was normal. Carvi-cal spine x-ray films and axial CT scans revealed a fracture at the base of the dens. It was slightly oblique leftup and rightdown, and the dens fragment was dis-placed 3mm lateral to the right. One week after the in-jury, this odontoid fracture was directly fixed with a compression screw by an anterior cervical approach. Immediately after the operation, his neck pain dis-appeared. He had only 4 days of bed rest and 2 months of external immobilization with a simple neck collar. He returned to his previous job 2 months after surgery without any limitation of his neck movement. At fol-low-up examination 16.5 months after the operation, x-ray films demonstrated complete fusion of the fracture and no problem about the screw such as displacement or breakage.

Direct screw fixation of an odontoid fracture via a transcervical approach was thought to be a reasonable method of treatment. For proper assembly of this method, the following two points are particularly recommended : a screw insertion perpendicular to the fracture plane and the use of an optimal screw with both the desired total and thread lengths.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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