J Korean Orthop Assoc.  2006 Dec;41(6):1008-1015.

Treatment of O dontoid Fractures with Single Anterior Screw Fixation

  • 1Department of Orthopedic Surgery, College of Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Jeonju, Korea. kysong@chonbuk.ac.kr


To evaluate the availability and safety of single anterior screw fixation in the treatment of type II and III odontoid process fractures through an analysis of the treatment outcomes.
This study analyzed 16 patients who underwent surgery between May 1996 and Oct. 2003 by single anterior screw fixation for type II and III odontoid process fractures with at least a 1 year follow up. The radiographic findings such as the fusion rate, union time, changes in the fracture shape, and metal migration were evaluated. In addition, the Robinson modification criteria were used for the clinical assessment.
There were 12 and 4 patients with Anderson and D'Alonzo type II and type III fractures, respectively. Of the 16 patients, 15 (93%) achieved bony union after an average of 13.8 weeks. There were 2 cases of malunion with a normal range of cervical motion, and 1 case requiring posterior fusion as a result of nonunion. A full range of cervical motion was maintained in 11 cases. Three cases had a limitation of less than 25% and 2 cases had a limitation greater than 25%.
Single anterior screw fixation is an effective treatment modality with a high fusion rate and low complication rates. However, precise preoperative planning and technical experience is essential for preventing unwanted complications.


Odontoid process fracture; Single anterior screw fixation; Complications
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