ABSTRACT
Four cases of operated odontoid process fractures associated with a fracture of the posterior arch of the atlas are presented. Three types of surgery were performed: atlas-axis fusion, occipitocervical fusion, and odontoid process screw fixation. Based on a literature review and our experience, the therapeutic management is discussed according to the type of odontoid fracture and the presence of neurological involvement, with a reminder that wiring is not indicated when C1 posterior arch continuity is compromised.
Subject(s)
Cervical Atlas/injuries , Fracture Fixation, Internal/methods , Odontoid Process/injuries , Spinal Fractures/surgery , Accidental Falls , Accidents, Traffic , Aged , Aged, 80 and over , Arthrodesis/adverse effects , Arthrodesis/methods , Atlanto-Axial Joint/injuries , Atlanto-Axial Joint/surgery , Bone Screws , Cervical Atlas/diagnostic imaging , Female , Follow-Up Studies , Fracture Fixation, Internal/adverse effects , Humans , Male , Multiple Trauma/diagnostic imaging , Multiple Trauma/surgery , Odontoid Process/diagnostic imaging , Postoperative Complications/diagnosis , Postoperative Complications/mortality , Radiography , Risk Assessment , Sampling Studies , Spinal Fractures/diagnostic imaging , Spinal Fractures/mortality , Spinal Fusion/adverse effects , Spinal Fusion/methods , Survival Rate , Time Factors , Young AdultABSTRACT
We report a case of bilateral congenital dislocation of the radial head discovered at the time of a fracture of the ulna. The dislocation was missed initially and when considered as part of the Monteggia fracture, raised a problem concerning the therapeutic approach. The purpose of this report is the emphasize the importance of careful physical examination before undertaking treatment of any lesion.
