$type 2 odontoid fracture icd 10$ $type 2 odontoid fracture icd 10$

Direct anterior screw fixation has been reported to result in successful fracture healing in around 80% of the cases at least in young patients. Following traditional posterior C1-C2 arthrodesis, union rates between 92,8 and 100% have been described in literature. To avoid these problems, surgical procedures providing internal fixation are practiced. Several facts may account for this, including a high rate of non-union, comorbidities and potential fatal complications – especially respiratory-related - due to prolonged external immobilisation. However, it is associated with a mortality rate of 26 to 47% in elderly patients. Non-operative treatment with a rigid brace may result in fracture healing. Treatment options for displaced odontoid fractures are either conservative or surgical. There is no universally accepted method concerning the management of these fractures, especially in elderly patients. In older patients, the injury commonly occurs in the setting of a low-energy trauma such as falls from a standing height with hyperextension of the neck resulting in posterior displacement of the odontoid. In younger patients, these fractures are usually the result of a high-energy trauma resulting from a motor vehicle accident or fall from a substantial height. There is a bimodal population distribution with peaks in early adulthood and in the elderly. The fracture occurs at the base of the odontoid between the level of the transverse ligament and the base of the odontoid process. The most common fracture types according to the Anderson and d’Alonso classification are type II fractures (65-74%), which are considered to be relatively unstable. As a result of demographic developments toward an older population, the incidence of this injury will further increase in the future. They represent the most common fractures of the cervical spine for patients older than 70 years and are the most common of all spinal fractures for patients older than 80 years. Odontoid fractures account for approximately 20% of all fractures of the cervical spine. We found the best clinical results with low rates of non-union as well as low mortality rates following posterior C1/C2 fusion making this our treatment of choice especially in an elderly patient collective.

$type 2 odontoid fracture icd 10$

Survival rates were significantly higher among the group of patients who were treated with anterior screw fixation or posterior C1/C2 fusion compared to the conservatively treated group. In patients with a posterior C1-C2 fusion, a bony fusion of the posterior elements was found in 15 of 16 cases (93%).

$type 2 odontoid fracture icd 10$

The non-union rate in this cohort was 77%.

$type 2 odontoid fracture icd 10$

The mean lateral displacement was 1.9 mm (range 0–5,8 mm) and a mean angulation of 29,1° (range 0-55°) was found.Īnterior screw fixation was carried out in 17 patients. In all other cases (n = 3), radiographs demonstrated non-union. In the non-operatively managed cohort, 11 patients (79%) died postoperatively within a mean period of 23 months. Methodsīetween June 2004 and February 2010, all patients older than 65 years (n = 47) with type II fractures of the odontoid according to the Anderson and D’Alonso classification were retrospectively reviewed. The aim of this study was to compare the outcome of the three treatment modalities in elderly patients. Surgical procedures include either anterior screw fixation of the odontoid or posterior C1/C2 fusion. Possible treatment options are either conservative or surgical. The management of these fractures is controversial. They represent the most common cervical spine injury for patients older than 70 years, the majority being type II fractures (65-74%), which are considered to be relatively unstable.

$type 2 odontoid fracture icd 10$

Type 2 odontoid fracture icd 10