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. 2021 Mar 29:24:280-283.
doi: 10.1016/j.jor.2021.03.012. eCollection 2021 Mar-Apr.

Risk factors of non-union in Anderson-D'Alonzo type III odontoid fractures with conservative treatment

Hiroyuki Koshimizu  1   2 , Hiroaki Nakashima  1   2 , Keigo Ito  3   2 , Kei Ando  1   2 , Kazuyoshi Kobayashi  1   2 , Fumihiko Kato  3   2 , Koji Sato  4   2 , Masao Deguchi  5   2 , Yuji Matsubara  6   2 , Hidenori Inoue  7   2 , Tokumi Kanemura  8   2 , Tetsuya Urasaki  9   2 , Hisatake Yoshihara  10   2 , Norimitsu Wakao  11   2 , Ryuichi Shinjo  12   2 , Shiro Imagama  1   2
Affiliations

Risk factors of non-union in Anderson-D'Alonzo type III odontoid fractures with conservative treatment

Hiroyuki Koshimizu et al. J Orthop. .

Abstract

Objective: The purpose of this study was retrospectively to analyze the risk factors for non-union in Anderson-D'Alonzo type III odontoid fractures with conservative treatment.

Methods: 25 patients with type III fractures were analyzed. Coronal and sagittal tilt as well as sagittal and lateral mass gaps were measured by using computed tomography.

Results: The non-union group had significantly higher age, greater coronal tilt and lateral mass gap. Especially, the lateral mass gap was >2 mm in all cases with non-union.

Conclusions: Higher age, coronal tilt, and lateral mass gap were significant risk factors for non-union.

Keywords: Anderson–D’Alonzo type III odontoid Fractures; Conservative treatment; Non-union; Risk factors.

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Figures

Fig. 1
Fig. 1
The measurement of (A) sagittal tilt, (B) sagittal gap, (C) coronal tilt, and (D) lateral mass gap on computed tomography.
Fig. 2
Fig. 2
Computed tomography (CT) images from a 92-year-old female who fell and diagnosed as an Anderson–D’Alonzo type III odontoid fracture. Sagittal and coronal CT showed (A) the sagittal gap: 0 mm, sagittal tilt angle: 8.0° (B), and lateral mass gap was 2.0 mm(C). The coronal tilt angle was 9.0°. The patient had neck pain without neurologic impairments. (D–F) Sagittal and coronal CT images at the final follow-up showed non-union despite hard collar treatment for 6 months. The white arrows indicate fracture lines for each panel.
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