Grauer Type IIA odontoid fracture

J.V. Mollá-Torró; J.Sales-Llopis

Neurosurgery Department, General University Hospital Alicante, Spain

• Odontoid fractures above C2 to pelvis posterior instrumented fusions: a single center's 11-year experience
• The use of Grauer classification in the management of type II odontoid fracture in elderly: Prognostic factors and outcome analysis in a single centre patient series
• Treatment of odontoid fracture combined with lower cervical spinal cord injuries without fracture or dislocation
• Surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation
• Odontoid bending stiffness after anterior fixation with a single lag screw: biomechanical study
• Surgical management of acute odontoid fractures: surgery-related complications and long-term outcomes in a consecutive series of 97 patients

Grauer Type IIA odontoid fracture: was defined as a minimally or non-displaced fracture with no comminution which could be treated with external immobilisation.

68-year-old man with a history of chronic ischemic heart disease, previous anterior ST-segment elevation myocardial infarction (IAMCEST) with a stent, arterial hypertension. He was admitted after a motorcycle accident.

Glasgow Coma Scale score of 15, conscious and oriented.

Odontoid fracture Type II without significant spinal cord compromise.

Left clavicle fracture.

Comminuted fracture of the left 5th metatarsal.

Wounds on the left ankle and sole of the foot.

Arterial blood gas, complete blood count, and biochemistry within normal limits.

Chest X-ray shows radiological cardiomegaly without clear infiltrates.

Cranial CT without significant alterations.

Cervical spine computed tomography: Odontoid process fracture with posterior epidural hematoma.

CT chest abdomen pelvis: Incidental lung nodules and clavicle fracture.

MRI cervical spine confirms odontoid process fracture without significant displacement, epidural hematoma, and signs of spondyloarthrosis.

Treatment and progression:

Suturing and washing of wounds on the left ankle.

Antibiotic therapy with cefazolin and gentamicin.

Rigid cervical collar.

Pain management and antibiotic therapy.

Discontinuation of Adiro (aspirin).

Anterior odontoid screw fixation

The importance of maintaining clinical and hemodynamic stability, as well as ongoing patient monitoring, is emphasized. Coordination among different medical specialties for comprehensive care is crucial. Additionally, the temporary suspension of certain medications, such as Adiro, and consideration of the clinical situation and potential interactions with other treatments are highlighted. Assessment of traumatic injuries through imaging studies is crucial for determining the appropriate management of the patient.