Both coronal and sagittal reconstructions should be obtained in suspected cases of odontoid fracture. Only 11 other case reports have been identified in a literature review. He was neurologically intact, and the fracture healed with immobilization in a rigid cervical brace. This report describes an unusual fracture of the odontoid process sustained by a 56-year-old male after falling down a flight of stairs. Vertical fractures, either sagittal or coronal, generally do not require operative treatment. Routine radiographs may not allow precise diagnosis. Sagittal or coronal fractures are uncommon and can best be visualized on coronal or sagittal reconstruction of CT scans. Speaking of the number of screw used in anterior screw fixation, two screw group showed better results in union rate.Fractures of the odontoid process of the axis usually occur transversely at the neck or base of the odontoid, are often displaced, and frequently require surgical fixation. SUMMARY: Anterior screw fixation was clinically and radiologically reliable surgical treatment option for type II odontoid process fracture. There was no significant differences between both groups(p=0.164, p=0.794, p=0.235). In all cases, reduction rate was 4.0mm(displacement in lateral view), 1.5° (angulation in lateral view), 1.5° (angulation in open mouth view) postoperatively, being 5.7mm, 2.5°, 2.8° in group I and 3.6mm, 3.8°, 0.6° in group II. The mean time to fusion was 11.3 weeks in all cases and there was no difference between both groups(p=0.521). In radiological results, union rate was 86.4%(19 patients) totally, 67%(6 patients) in group I and 100%(13 patients) in group II retrospectively(p=0.045). There was no case with fair or poor results in both groups including nonunited case. RESULTS: In clinical results, excellent functional outcome were obtained in 6 cases of group I and 10 cases of group II, while good functional outcome in 3 cases of group I and 3 cases of group II according to Erric and James' criteria(p=0.477). The statistical analysis using the two-way ANOVA and chi-square test was performed. Eric and James' functional outcome scale was used for the functional results. The amount of correction of initial displacement and angulation, bone union and perioperative complications were selected as assessment criteria. There were 19 fresh odontoid fractures, 3 delayed union preoperatively. Nine patients were operated by anterior fusion using one screw(group I) and 13 patients using two screws(group II). 1997, 24 patients were operated by anterior screw fixation for the type II odontoid process fracture, but 2 patients were lost to follow-up and we analyzed 22 patients with average 68 month followup(range: 24~142 months).
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SUMMARY OF BACKGROUND DATA: There are few data on the surgical results of type II odontoid process fracture in Korea. OBJECTIVES: To determine the utility of anterior screw fixation for type II odontoid process fracture and assess the influence of several factors including the number of screw on results. STUDY DESIGN: A retrospective study was performed in 22 cases undergoing anterior screw fixation for type II odontoid process fracture.