How is a dens fracture treated?
Treatment options for type II odontoid fractures can be nonsurgical or surgical. Nonsurgical measures include immobilization, prevent or restrict movement, in a cervical collar or halo vest. Surgery may be required if the fracture has resulted in neurologic symptoms and/or the spine has become unstable.
How long does a dens fracture take to heal?
Most consider a type I odontoid fracture a stable fracture and treat for six to 12 weeks in a rigid cervical orthosis (hard cervical collar).
What is a den fracture?
A fracture of the odontoid bone (also called the dens), is an upward extension of C2 cervical vertebrae (i.e., axis) up into the C1 cervical vertebrae (i.e., atlas) and is held in place partially by the alar, apical and transverse ligaments. There are three types of dens fractures with type II being the most common.
How serious is a dens fracture?
The odontoid process, also called the dens, is a protuberance of the axis. Life-threatening fractures can occur as a result of forces acting on this anatomical structure due to its proximity to the spinal cord and brainstem.
Which dens fractures are unstable?
Type II fractures are the most common type of odontoid fracture. These fractures are unstable and prone to nonunion because they occur in an area of relatively reduced osseous vascularity. Therefore, rigid halo immobilization or surgical stabilization is often necessary. Hadley et al.
What is the purpose of the dens?
It is a blunt tooth–like process that projects upward. It is also referred to as the ‘dens’ (Latin for ‘tooth’) or odontoid process. The dens provides a type of pivot and collar allowing the head and atlas to rotate around the dens.
How long does it take for a Jefferson fracture to heal?
What’s recovery like? If surgery is needed, recovery will likely take about 12 weeks. This is regardless of the type of surgery. If the fracture is minor, you may be able to get by with wearing a neck brace for six to eight weeks.
Why is it called Jefferson fracture?
It is named after the British neurologist and neurosurgeon Sir Geoffrey Jefferson, who reported four cases of the fracture in 1920 in addition to reviewing cases that had been reported previously.
What are the different types of dens fractures?
Dens (Odontoid) Fractures. Type II = Fracture at the base of the dens in a transverse plane (most common type; a non-union would be treated with a halo vest or surgical fixation). Type III = Fracture extends down into the body of C2 and is considered unstable (treated with halo or anterior screw fixation)
What are the different types of fracture non-union?
There are different types of fracture non-union with various imaging characteristics: hypertrophic: abundant callus formation; radiolucent line (unmineralized fibrocartilage) at the nonunion site atrophic: bony surfaces partially resorbed; no callus formation; osteopenia; sclerotic avascular bone segments; segmental bone loss 1.
What should I do if I have a dens fracture?
Types II & III are commonly treated with a halo vest or surgical fixation. If starting out with basic radiographs, you would assess by doing an open mouth or odontoid view. If an abnormality is present, a CT or MRI of the head and c-spine can more definitively determine the type of dens fracture.
What causes an eutrophic non-union bone fracture?
Eutrophic: caused by a combination of factors. Hypertrophic non-union fractures are a result of instability of the fixation or metalwork used to fix a fracture. On x-rays we can see a significant lump of new bone formation with a tiny line running where the previous fracture was.