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Systematic Review on Surgical and Nonsurgical Treatment of Type II Odontoid Fractures in the Elderly
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.ORCID iD: 0000-0002-2724-6372
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.ORCID iD: 0000-0002-2111-6868
2014 (English)In: BioMed Research International, ISSN 2314-6133, Vol. 2014, 231948- p.Article, review/survey (Refereed) Published
Abstract [en]

Odontoid fractures type II according to Anderson and d’Alonzo are not uncommon in the elderly patients. Still, due to the paucity of evidence the published treatment guidelines are far from equivocal. This systematic review focuses on the published results of type II odontoid fracture treatment in the elderly with regard to survival, nonunion, and complications. After a systematic literature research 38 publications were included. A cumulative analysis of 1284 published cases found greater survival if elderly patients with odontoid fractures type II received surgical treatment (RR = 0.64). With regard to nonunion in 669 published cases primary posterior fusion had the best fusion results. The systematic literature review came to the following conclusions. (1) Surgical stabilisation of odontoid fractures type II improves survival in patients between 65 and 85 years of age compared to nonsurgical treatment. (2) Posterior atlantoaxial fusion for odontoid fractures type II in the elderly has the greatest bony union rate. (3) Odontoid nonunion is not associated with worse clinical or functional results in the elderly. (4) The complication rate of nonsurgical treatment is similar to the complication rate of surgical treatment of odontoid fractures type II in the elderly.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2014. Vol. 2014, 231948- p.
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Orthopedics
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URN: urn:nbn:se:uu:diva-218396DOI: 10.1155/2014/231948ISI: 000331736300001OAI: oai:DiVA.org:uu-218396DiVA: diva2:695545
Available from: 2014-02-11 Created: 2014-02-11 Last updated: 2017-11-22Bibliographically approved
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