| Abstrakt: |
Odontoid fractures are rare in children; they may, however, occur at any age with a prevalence in younger children. Below the age of 9, there is almost exclusively a separation of the subdental synchondrosis, whereas in children older than 9 years, the basal odontoid fracture resembles the adult type. Motor vehicle accidents (MVA) are the dominant trauma. Clinically, a substantial lesion of the upper cervical spine cannot be excluded the symptoms of odontoid fracture, such as neck pain or neck stiffness, being subtle and unspecific. Therefore, the diagnosis of odontoid fractures is based on radiographic screening of traumatized cervical spines with a standard three-view program (anteroposterior, lateral from the occiput on Th1, transoral dens view). Computed tomography (CT) and magnetic resonance imaging (MRI) are reserved to special indications. Acute odontoid fracture is mainly treated conservatively, preferably with a Minerva cast. In exceptional cases, operation with preservation of C1/C2 mobility may be indicated. The genesis of os odontoideum may be traumatic and is due to untreated odontoid fractures in children below the age of 2.5 years. Chronic atlanto-axial instability is treated by segmental fusion. [ABSTRACT FROM AUTHOR] |
