Halo jacket in odontoid fractures type II and III

• Published in: Archives of orthopaedic and trauma surgery Vol. 123; no. 2-3; pp. 64 - 67
• Main Authors: KOMADINA, Radko, BRILEJ, Drago, KOSANOVIC, Milos, VLAOVIC, Miodrag
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-04-2003; Springer Nature B.V
• Subjects: Adolescent; Adult; Biological and medical sciences; Female; Fracture Fixation - methods; Humans; Immobilization; Male; Medical sciences; Middle Aged; Odontoid Process - injuries; Orthopedic surgery; Retrospective Studies; Spinal Fractures - therapy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Human; Fixator; Prognosis; Odontoid process of axis; Diseases of the osteoarticular system; Osteosynthesis; Fracture; Spine disease; Trauma; External fixators; Halo traction; Orthopedic surgery; Treatment; Fractures; External; Technique; Halo; Cervical spine; Odontoid process
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-003-0473-4

The treatment of odontoid fractures remains controversial. The late results of 14 patients with Anderson D'Alonzo type II and III treated with halo jacket from 1995 to 1999 are presented. The fractures were reduced under image intensifier and stabilized by halo jacket. The immobilization period was 12 weeks. After 1 year, the fracture was roentgenologically consolidated in 12 out of 14 patients (85.7%), and all the patients were without neurological deficit. Nine patients (64.3%) were without subjective complaints, five had a reduced range of motion. Painful motion appeared in four patients (28.6%), and cervical stiffness was noted in five (35.7%). We recommend halo jacket for the treatment of most type II and III odontoid fractures which are unstable or displaced 6 mm and more, except for patients with tetraplegia. Fractures with minimal displacement and without neurological deficit were treated conservatively with rigid collars. In our institution, internal fixation was performed in selected cases. The presence of neurological deficit and the anatomic properties of the fracture site crucially influence the choice of treatment.