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DOI: 10.1055/s-0043-1770979
Malunion in a Self-stabilized Fracture of the Odontoid Process Type II with a Chronic Anterior Atlantoaxial Subluxation in a Neurologically Intact Patient: A Case Report
Article in several languages: português | English
Abstract
Atalanto-occipital dislocations with type II fractures of the odontoid process are rare, reporting 7 cases for every 784 upper cervical spine injuries, an incidence of <0.3% and are related to a high rate of morbidity and mortality. Regarding C2 fractures, the most common are in the odontoid process, representing 7%, classified by Anderson and D'Alonso according to their level, with the highest rate of pseudarthrosis in zone II of up to 85% are caused mainly by car accidents. In the acute event, there is no consensus regarding its optimal management. We performed a complete anamnesis and a physical examination in our institution. A systematic review of case reports was carried out with the keywords “mal-union, type II odontoid process fracture, chronic atlantoaxial subluxation” in four different databases, and a comparative analysis of the cases found was performed. There were not found identical cases to the one in our report, 9 similar case reports were published with the general differences of a pseudarthrosis of the odontoid process, as well as neurological alterations in symptomatic patients and the consequent surgical treatment.
Observing a patient with a type II odontoid process fracture consolidating viciously and a stable anterior atlantoaxial subluxation without neurological alterations is rare. We determined to maintain expectant management with annual follow-up.
Financial Support
The authors declare that the present survey has not received any specific funding from public, commercial, or not-for-profit funding agencies.
Work carried out at the Servicio de Cirugía de Columna, Instituto Nacional de Rehabilitación, Mexico City, Mexico.
Publication History
Received: 09 January 2023
Accepted: 12 April 2023
Article published online:
27 December 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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