[Surgical management of a dens fracture in a 3-year-old child. Clinical case report and discussion with reference to the literature]

Abstract

Because of the special features of subdental synchondrosis, fracture of the odontoid process in childhood can be seen as a separate entity. Among the rare fractures of the cervical spine in children this type is the most common. Ontogenetically, the subdental synchondrosis must be regarded as an intervertebral disc and not as a growth plate. Usually conservative treatment with a halo fixateur or minerva jacket leads to consolidation. We report on the case of a 3-year-old boy with a fracture of the odontoid process who was treated operatively with anterior log screw fixation because of extensive anterior dislocation and tetraplegia. Five months after the operation bony consolidation was achieved and the screws could be removed. Full neurological recovery had occurred by this time.