C2 Dens Fracture

FACTS

 

HPI

 

PHYSICAL EXAM

IMAGING

MRI C-spine with STIR sequences in coronal and axial planes
  • evaluate integrity of transverse ligament. If transverse ligament violated, C1/C2 translation can happen hence cannot do odontoid screw fixation (need C1-C2 fusion)
A/P
 

Factors predicting non-union

  1. comminution of dens
  1. displacement ≥ 5 mm
  1. > 40 years old
  1. posteriorly displaced fx
  1. neuro deficits
  • Factors necessitating surgical stabilization
  1. displacement ≥ 5mm
  1. prior nonuinion
  1. instability of fracture in rigid immobilization