Patients were treated in either a hard collar orthosis or halo vest and were followed for fracture union and stability. Fractures were categorized as high- or low-energy fracture with high-energy fractures defined as those with lateral mass comminution (>50%) or secondary fracture lines into the pars interarticularis or vertebral body. Case seriesĪcute Type III odontoid fractures were identified at a single institution from 2008 to 2015. Always check the coronal view, which more readily demonstrates the relationship of the fracture to the VB.
A type III odontoid fracture may be misinterpreted as odontoid fracture type II on sagittal CT because the fracture may appear to lie above the vertebral body ( VB). In general, the Type III fracture is believed to have high healing potential due to the large fracture surface area through cancellous bone 3). Biomechanically, complex fractures exhibit the same deforming forces as all odontoid fractures with additional instability in the rotatory or coronal plane 2). At trauma centers, a complex, high-energy subtype exists that radiographically fits the definition of Type III odontoid fracture but of unknown clinical context.įractures with >50% comminution of the lateral mass or secondary fracture lines extending into the vertebral body or pars interarticularis were classified as complex by Niemeier et al. In clinical practice, the Type III fracture encompasses a heterogeneous collection of morphologically different fractures of varying etiologies and patient demographics. The difference is where the fracture line occurs. Type III odontoid fractures occur secondary to hyperextension or hyperflexion of the cervical spine in a similar manner to type II odontoid fractures. Type III fractures account for 39% of all odontoid fractures 1). (The amount of radiation is small–less than the radiation in half of one CT scan.) This scan helps identify damaged bones.A type III odontoid fracture is a fracture through the body of the C2 vertebrae and may involve a variable portion of the C1 and C2 facets. Nuclear bone scan: a diagnostic procedure in which a radioactive substance is injected into the body to measure activity in the bones.CT scans are more detailed than general X-rays. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. Computed tomography scan (CT scan): a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of the body.Magnetic resonance imaging (MRI): a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.X-rays: test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs on film.If a Type II Odontoid Fracture is suspected, the doctor may order the following diagnostic procedures: The doctor will take a complete medical history and perform a complete physical examination. This makes them the most likely to require surgery. Type II fractures are considered the least stable of the odontoid fractures. In an unstable fracture, the bone is more likely to move out of its normal position and alignment. A stable fracture may “set” and heal itself. In a stable fracture, the bone does not move out of its normal anatomical position and alignment. Some fractures are considered stable, and some are unstable. In a Type III fracture, the bone is broken below the base of the peg. In a Type II fracture, the most common type, the peg is broken at its base. In a Type I odontoid fracture, just the tip of the bone is broken. In an odontoid fracture, that peg of bone is broken. The odontoid process sticks up from the front of C2 and fits into a groove in C1. It is about the size of the tip of a pinky finger. One of the unique features of this joint is a peg of bone called the odontoid process (sometimes called the dens). This is the joint that allows the head to rotate from side to side, bend forward and bend backward. The joint between C2 and the vertebra above, C1, has an outstanding range of motion. The bone involved in odontoid fracture is the second vertebra, C2, high up in the neck. Odontoid = A peg-like part of the second bone in the neckĪ type II odontoid fracture is a break that occurs through a specific part of C2, the second bone in the neck.īones of the spine are called vertebrae.
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