Conservative Management of Odontoid Peg Fractures, long term follow up



Osman A, Alageli NA, Short DJ, Masri WSE.


J Clin Orthop Trauma. 2017 Apr-Jun;8(2):103-106. doi: 10.1016/j.jcot.2017.06.003. Epub 2017 Jun 4.


OBJECTIVE: The aim of the study was to look at the long-term effects of conservative management of odontoid peg fractures. METHODS: We reviewed 48 consecutive patients with type II (32) and 16 type III, odontoid peg fractures. The clinical & radiological outcomes were assessed over an average period of follow up of 8 years. Union rate was determined and we discussed several factors that may affect it. Patients were treated conservatively with an average period of bed rest of 4 weeks followed by bracing for an average of 9 weeks. RESULTS: Bony union was established in 25 of 32 (78%) type II fractures. Of 7 cases of no bony union 4 were stable probably with fibrous union. 3 remained unstable. In 13 of 16(83%) type III fractures bony union was established. 2 of the 3 with no bony union were considered stable. CONCLUSION: Osseous non-union was higher in patients with displacement of >5 mm, but there is no correlation between union and age, gender or angulation of the fracture in both types.

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Link/DOI: 10.1016/j.jcot.2017.06.003