Fractures of the odontoid in children with an open basilar synchondrosis
Fractures of the odontoid in children with an open basilar synchondrosis differ from those which occur in older children and adults. We have reviewed the morphology of these fractures and present a classification system for them. There were four distinct patterns of fracture (types IA to IC and type...
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Veröffentlicht in: | Journal of bone and joint surgery. British volume 2009-06, Vol.91 (6), p.789-796 |
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container_title | Journal of bone and joint surgery. British volume |
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creator | HOSALKAR, H. S GREENBAUM, J. N FLYNN, J. M CAMERON, D. B DORMANS, J. P DRUMMOND, D. S |
description | Fractures of the odontoid in children with an open basilar synchondrosis differ from those which occur in older children and adults. We have reviewed the morphology of these fractures and present a classification system for them. There were four distinct patterns of fracture (types IA to IC and type II) which were distinguished by the site of the fracture, the degree of displacement and the presence or absence of atlantoaxial dislocation. Children with a closed synchondrosis were classified using the system devised by Anderson and D'Alonzo. Those with an open synchondrosis had a comparatively lower incidence of traumatic brain injury, a higher rate of missed diagnosis and a shorter mean stay in hospital. Certain subtypes (type IA and type II) are likely to be missed on plain radiographs and therefore more advanced imaging is recommended. We suggest staged treatment with initial stabilisation in a Halo body jacket and early fusion for those with unstable injuries, severe displacement or neurological involvement. |
doi_str_mv | 10.1302/0301-620X.91B6.22173 |
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S ; GREENBAUM, J. N ; FLYNN, J. M ; CAMERON, D. B ; DORMANS, J. P ; DRUMMOND, D. S</creator><creatorcontrib>HOSALKAR, H. S ; GREENBAUM, J. N ; FLYNN, J. M ; CAMERON, D. B ; DORMANS, J. P ; DRUMMOND, D. S</creatorcontrib><description>Fractures of the odontoid in children with an open basilar synchondrosis differ from those which occur in older children and adults. We have reviewed the morphology of these fractures and present a classification system for them. There were four distinct patterns of fracture (types IA to IC and type II) which were distinguished by the site of the fracture, the degree of displacement and the presence or absence of atlantoaxial dislocation. Children with a closed synchondrosis were classified using the system devised by Anderson and D'Alonzo. Those with an open synchondrosis had a comparatively lower incidence of traumatic brain injury, a higher rate of missed diagnosis and a shorter mean stay in hospital. Certain subtypes (type IA and type II) are likely to be missed on plain radiographs and therefore more advanced imaging is recommended. We suggest staged treatment with initial stabilisation in a Halo body jacket and early fusion for those with unstable injuries, severe displacement or neurological involvement.</description><edition>British volume</edition><identifier>ISSN: 0301-620X</identifier><identifier>ISSN: 2049-4394</identifier><identifier>EISSN: 2044-5377</identifier><identifier>EISSN: 2049-4408</identifier><identifier>DOI: 10.1302/0301-620X.91B6.22173</identifier><identifier>PMID: 19483234</identifier><identifier>CODEN: JBSUAK</identifier><language>eng</language><publisher>London: British Editorial Society of Bone and Joint Surgery</publisher><subject>Adolescent ; Age Factors ; Biological and medical sciences ; Case-Control Studies ; Child ; Child, Preschool ; Diseases of the osteoarticular system ; Early Diagnosis ; Female ; Humans ; Injuries of the limb. Injuries of the spine ; Male ; Medical sciences ; Odontoid Process - diagnostic imaging ; Odontoid Process - injuries ; Orthopedic surgery ; Radiography ; Retrospective Studies ; Spinal Fractures - classification ; Spinal Fractures - diagnostic imaging ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Traumas. Diseases due to physical agents</subject><ispartof>Journal of bone and joint surgery. 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S</creatorcontrib><creatorcontrib>GREENBAUM, J. N</creatorcontrib><creatorcontrib>FLYNN, J. M</creatorcontrib><creatorcontrib>CAMERON, D. B</creatorcontrib><creatorcontrib>DORMANS, J. P</creatorcontrib><creatorcontrib>DRUMMOND, D. S</creatorcontrib><title>Fractures of the odontoid in children with an open basilar synchondrosis</title><title>Journal of bone and joint surgery. British volume</title><addtitle>J Bone Joint Surg Br</addtitle><description>Fractures of the odontoid in children with an open basilar synchondrosis differ from those which occur in older children and adults. We have reviewed the morphology of these fractures and present a classification system for them. There were four distinct patterns of fracture (types IA to IC and type II) which were distinguished by the site of the fracture, the degree of displacement and the presence or absence of atlantoaxial dislocation. Children with a closed synchondrosis were classified using the system devised by Anderson and D'Alonzo. Those with an open synchondrosis had a comparatively lower incidence of traumatic brain injury, a higher rate of missed diagnosis and a shorter mean stay in hospital. Certain subtypes (type IA and type II) are likely to be missed on plain radiographs and therefore more advanced imaging is recommended. We suggest staged treatment with initial stabilisation in a Halo body jacket and early fusion for those with unstable injuries, severe displacement or neurological involvement.</description><subject>Adolescent</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Diseases of the osteoarticular system</subject><subject>Early Diagnosis</subject><subject>Female</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Odontoid Process - diagnostic imaging</subject><subject>Odontoid Process - injuries</subject><subject>Orthopedic surgery</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Spinal Fractures - classification</subject><subject>Spinal Fractures - diagnostic imaging</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0301-620X</issn><issn>2049-4394</issn><issn>2044-5377</issn><issn>2049-4408</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV1LHTEQhkNR6lH7D0oJQnu3p_nafFyq1A8QvGnBuzDJZjmRPckx2UX8992tBwveeDXM8MzLvPMi9JWSNeWE_SSc0EYy8rA29EKuGaOKf0IrRoRoWq7UAVq9IUfouNZHQohoW_4ZHVEjNGdcrNDNVQE_TiVUnHs8bgLOXU5jjh2OCftNHLoSEn6O4wZDwnk3Nw5qHKDg-pL8Jqeu5BrrKTrsYajhy76eoD9Xv35f3jR399e3l-d3jRfcjA3oToVOKAdSGyEJVYEr8BKMpz6Q3ph55sBzACecdqKjyhsKzjnuhdL8BP141d2V_DSFOtptrD4MA6SQp2ql4pRqpj4EGTFSy3ZRPHsHPuappNmEZcxoIrRkMyReIT-7rSX0dlfiFsqLpcQuedjl2XZ5tl3ysP_ymNe-7bUntw3d_6V9ADPwfQ9A9TD0BZKP9Y1jtG3nKzn_C_eAkqA</recordid><startdate>20090601</startdate><enddate>20090601</enddate><creator>HOSALKAR, H. S</creator><creator>GREENBAUM, J. N</creator><creator>FLYNN, J. M</creator><creator>CAMERON, D. B</creator><creator>DORMANS, J. P</creator><creator>DRUMMOND, D. 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Injuries of the spine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Odontoid Process - diagnostic imaging</topic><topic>Odontoid Process - injuries</topic><topic>Orthopedic surgery</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Spinal Fractures - classification</topic><topic>Spinal Fractures - diagnostic imaging</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>HOSALKAR, H. S</creatorcontrib><creatorcontrib>GREENBAUM, J. N</creatorcontrib><creatorcontrib>FLYNN, J. M</creatorcontrib><creatorcontrib>CAMERON, D. B</creatorcontrib><creatorcontrib>DORMANS, J. P</creatorcontrib><creatorcontrib>DRUMMOND, D. 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S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fractures of the odontoid in children with an open basilar synchondrosis</atitle><jtitle>Journal of bone and joint surgery. British volume</jtitle><addtitle>J Bone Joint Surg Br</addtitle><date>2009-06-01</date><risdate>2009</risdate><volume>91</volume><issue>6</issue><spage>789</spage><epage>796</epage><pages>789-796</pages><issn>0301-620X</issn><issn>2049-4394</issn><eissn>2044-5377</eissn><eissn>2049-4408</eissn><coden>JBSUAK</coden><abstract>Fractures of the odontoid in children with an open basilar synchondrosis differ from those which occur in older children and adults. We have reviewed the morphology of these fractures and present a classification system for them. There were four distinct patterns of fracture (types IA to IC and type II) which were distinguished by the site of the fracture, the degree of displacement and the presence or absence of atlantoaxial dislocation. Children with a closed synchondrosis were classified using the system devised by Anderson and D'Alonzo. Those with an open synchondrosis had a comparatively lower incidence of traumatic brain injury, a higher rate of missed diagnosis and a shorter mean stay in hospital. Certain subtypes (type IA and type II) are likely to be missed on plain radiographs and therefore more advanced imaging is recommended. We suggest staged treatment with initial stabilisation in a Halo body jacket and early fusion for those with unstable injuries, severe displacement or neurological involvement.</abstract><cop>London</cop><pub>British Editorial Society of Bone and Joint Surgery</pub><pmid>19483234</pmid><doi>10.1302/0301-620X.91B6.22173</doi><tpages>8</tpages><edition>British volume</edition><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Age Factors Biological and medical sciences Case-Control Studies Child Child, Preschool Diseases of the osteoarticular system Early Diagnosis Female Humans Injuries of the limb. Injuries of the spine Male Medical sciences Odontoid Process - diagnostic imaging Odontoid Process - injuries Orthopedic surgery Radiography Retrospective Studies Spinal Fractures - classification Spinal Fractures - diagnostic imaging Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Traumas. Diseases due to physical agents |
title | Fractures of the odontoid in children with an open basilar synchondrosis |
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