Anterior fixation of odontoid fractures: results.

Ferraz Montenegro Lobo, João Pedro; Veludo Moutinho, Veludo Moutinho; Martingo Serdoura, António Francisco; Fernandes Oliveira, Carolina; Rodrigues Pinho, André

Publication

Anterior fixation of odontoid fractures: results.

2018Journal article

dc.contributor.author	Ferraz Montenegro Lobo, João Pedro
dc.contributor.author	Veludo Moutinho, Veludo Moutinho
dc.contributor.author	Martingo Serdoura, António Francisco
dc.contributor.author	Fernandes Oliveira, Carolina
dc.contributor.author	Rodrigues Pinho, André
dc.date.accessioned	2018-12-03T19:23:33Z
dc.date.available	2018-12-03T19:23:33Z
dc.date.issued	2018
dc.description.abstract	OBJECTIVE: To evaluate the clinical and radiological outcomes of the surgical treatment in patients diagnosed with odontoid fracture who underwent open reduction and internal fixation (ORIF) with screws. METHODS: This was a retrospective study with nine patients. Pain (visual analog scale [VAS]) and neurological status (Frankel scale) were assessed. The neck disability index (NDI) and the post-operative cervical range of motion were calculated. The cervical spine was radiologically evaluated (X-ray and CT) pre- and postoperatively. RESULTS: The mean age of patients was 70 years. All patients presented type IIb (Grauer classification) fractures, with a mean deviation of 2.95 mm. Two patients had subaxial lesions. The mean follow-up was 30 months. The mean time from trauma to surgery was seven days. The pre-operative Frankel score was E in all except one patient (B), in whom a post-operative improvement from B to D was observed. Post-operative pain was 2/10 (VAS). A total of 77% of patients presented a mild or moderate disability (NDI). Six patients regained full range of cervical movement, and bone union required approximately 14 weeks. Pseudarthrosis complications were observed in two patients (77% union rate), one patient presented screw repositioning and one case, dysphonia. CONCLUSION: Delayed diagnosis is still an issue in the treatment of odontoid fractures, especially in elderly patients. Concomitant lesions, especially in younger patients, are not uncommon. The literature presents high fusion rates with ORIF (≥80%), which was also observed in the present study. However, surgical success depends on proper patient selection and strict knowledge of the technique. This pathology presents a reserved functional prognosis in the medium-term, especially in the elderly.	pt_PT
dc.description.version	info:eu-repo/semantics/publishedVersion	pt_PT
dc.identifier.citation	Send to Rev Bras Ortop. 2017 Nov 14;53(5):532-536	pt_PT
dc.identifier.doi	10.1016/j.rboe.2017.07.010
dc.identifier.issn	2255-4971
dc.identifier.uri	http://hdl.handle.net/10400.26/25179
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.publisher	Elsevier Editora Ltda.	pt_PT
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/	pt_PT
dc.subject	Bone screws	pt_PT
dc.subject	Cervical injury	pt_PT
dc.subject	Fracture fixation	pt_PT
dc.subject	Odontoid process	pt_PT
dc.subject	Spinal fracture	pt_PT
dc.title	Anterior fixation of odontoid fractures: results.	pt_PT
dc.type	journal article
dspace.entity.type	Publication
oaire.citation.endPage	536	pt_PT
oaire.citation.issue	5	pt_PT
oaire.citation.startPage	532	pt_PT
oaire.citation.volume	53	pt_PT
rcaap.rights	openAccess	pt_PT
rcaap.type	article	pt_PT