Administration of acute mixed fractures of the atlas and axis: A retrospective research of two trauma facilities.
J Craniovertebr Junction Backbone. 2017 Oct-Dec;eight(four):311-315
Authors: DiDomenico J, Abode-Iyamah Ok, Khanna R, Roberts H, Hitchon PA, Smith ZA, Dahdaleh NS
Background: Administration of mixture fractures of the atlas and axis varies from nonoperative immobilization to selective early surgical intervention. On this research, we current our expertise in managing these accidents.
Supplies and Strategies: Digital databases from two degree 1 trauma facilities had been queried to determine all sufferers identified with C1-C2 mixture fractures from 2009 to current. Affected person demographics, fracture traits, therapy modality, problems, Frankel scores, and fusion standing had been collected. Sufferers had been separated into operative and nonoperative cohorts, and comparisons had been made between the 2 teams.
Outcomes: Forty-eight sufferers had been included, of which 19 acquired operative administration and 29 had been handled nonoperatively. The imply age was 76.1 and 75.three years, respectively (P = zero.877). Frankel grade distribution was related on presentation in each teams, with most being neurologically intact. C1 fractures of each the anterior and posterior arch had been current in 41.2% sufferers present process fusions in comparison with 27.6% of sufferers handled nonoperatively. No important variations in comorbidities, neurologic deficits, or radiographic measurements had been noticed throughout the 2 teams.
Conclusions: This research demonstrates the number of therapy methods used for the administration of mixed C1-C2 fractures. Sufferers managed operatively are inclined to have each anterior and posterior C1 arch fractures, whereas sufferers managed nonoperatively are inclined to have both anterior or posterior arch fractures. On the whole, therapies must be tailor-made to sufferers’ wants relying on the soundness of the fractures, neurological state, and medical comorbidities.
PMID: 29403241 [PubMed]