TITLE:
Review of Management of Type-2 Odontoid Fracture in Elderly
AUTHORS:
Jagodish Chandra Ghosh
KEYWORDS:
Odontoid, Fracture, Type-2, Management, Review
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.11 No.1,
January
26,
2021
ABSTRACT: Odontoid fracture accounts for 15%-20% of all cervical spine injuries. Among the odontoid fracture, type-2 fractureisthe most common variety. This injury is associated with a high incidence of morbidity, mortality andnonunion intheelderly irrespective of mode of treatment. Management of odontoid fracture cannot be standardized till to date and ideal treatment for type-2 odontoid fractures still hassome controversial issues. Objective of this review is to findacontroversial aspect of management along with opinion to find out a standard guideline by searching the literature in Pubmed and Googlescholar databases withkey words:odontoid, fracture, type-2, management, nonoperative and operative management. Nonoperative treatment with halo vest is associated with very high rate of complication in elderly patient. When conservative treatment of this fractures is indicated that should be carried out with hard cervical collar or cervicothoracic orthosis. Current studies suggest that surgical management of odontoid fractures may offer a protective benefit but it is limited to patients younger than 75 years of age. Though surgical treatment hasabetter outcome, itis also limited by the co-mobidities and hazards of anesthesia and surgery in elderly patients. Conservative treatment of this fracture intheelderly should preferably be carried out with hard collar or avoiding halo vest. Surgical treatment is associated with little advantage but should be selected with proper attention to age, comorbidities, fracture geometry and it is better to individualize the treatment strategy.