1,441 results match your criteria C1 Fractures


Reevaluation of a classification system: stable and unstable odontoid fractures in geriatric patients-a radiological outcome measurement.

Eur J Trauma Emerg Surg 2022 May 21. Epub 2022 May 21.

Department of Trauma Surgery, KABEG-Klinikum Klagenfurt a.W, Klagenfurt, Austria.

Objectives: We carried out a retrospective cohort study to differentiate geriatric odontoid fractures into stable and unstable and correlated it with fracture fusion rates. Results are based on the literature and on our own experience. The authors propose that the simple Anderson and D'Alonzo classification may not be sufficient for geriatric patients. Read More

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Temporary posterior C1-2 instrumentation without fusion for treatment of displaced atlantoaxial fractures.

World Neurosurg 2022 May 16. Epub 2022 May 16.

Department of Neurosurgery, University of Illinois College of Medicine at Peoria, OSF HealthCare Illinois Neurological Institute, 530 NE Glen Oak Avenue, Peoria, IL, 61637.

Objective: We describe open reduction internal fixation (ORIF) with posterior C1-2 instrumentation without fusion to treat displaced atlantoaxial fractures with later instrumentation removal. Potential benefits are improved fracture healing while maintaining C1-2 mobility and avoiding complications of halo vest immobilization (HVI).

Methods: A retrospective review identified 14 patients (mean age 44 years) with displaced atlantoaxial fractures treated with ORIF without fusion. Read More

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Operative Technique for Resection of a Ventral Trans-Dural Retro-Odontoid Pannus: A 2-Dimensional Operative Video.

World Neurosurg 2022 May 5. Epub 2022 May 5.

SUNY Upstate Medical University, Department of Neurosurgery, 750 East Adams Street, Syracuse, NY 13210, USA; University of North Carolina, Department of Neurosurgery (current institution), Physicians Office Building, 170 Manning Drive, Campus Box 7060, Chapel Hill, NC 27599, USA.

Retro-odontoid pseudotumors are rare inflammatory complications of atlantoaxial instability often associated with cervical degenerative disease and rheumatoid arthritis. While propagation of these lesions has been shown to cause spinal cord compression and cervical myelopathy, intradural extension has rarely been reported. In this manuscript and two-dimensional illustrative intra-operative video, we demonstrate cervical decompression, removal of the intradural component, and stabilization with C1-2 instrumentation utilizing a posterior approach. Read More

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Healing process of Type II odontoid fractures after C1-C2 posterior screw fixation: Predictive factors for pseudoarthrosis.

Surg Neurol Int 2022 31;13:116. Epub 2022 Mar 31.

Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, United States.

Background: The healing process after C1-C2 posterior screw fixation (C1-C2 PSF) for odontoid fractures is not well understood. Here, we evaluated such processes and identified factors potentially contributing to pseudoarthroses following fusions for Type II odontoid fractures.

Methods: Pre- and post-operative cervical radiographs and computed tomography (CT) images from 15 patients with preoperative Type II odontoid fractures who underwent C1-C2 PSF were retrospectively reviewed. Read More

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Anterior transcervical release with posterior atlantoaxial fixation for neglected malunited type II odontoid fractures.

Surg Neurol Int 2022 8;13:132. Epub 2022 Apr 8.

Department of General Surgery, Hayatabad Medical Complex, Peshawar, Pakistan.

Background: Type 2 odontoid fractures are associated with a high rate of nonunion without surgical treatment. If neglected, they may become fixed in an abnormal position, causing progressive myelopathy. Conventionally, odontoidectomy or transoral release is performed to relieve symptoms in such cases. Read More

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Case of pedicle lag screw fixation for oblique axis body and pars fractures with displacement.

Surg Neurol Int 2022 8;13:133. Epub 2022 Apr 8.

Department of General Surgery, Hayatabad Medical Complex, Hayatabad, Peshawar, Pakistan.

Background: Multiple axis fractures with instability are rare and appropriate treatment modalities have not been established.

Case Description: A 33-year-old male presented with severe neck pain, bilateral upper-extremity numbness, and brisk reflexes in both lower extremities of 14 days' duration after a car accident. The cervical CT revealed an oblique C2 body fracture and asymmetrical neural ring fractures, while the MRI showed a normal C2-3 disk. Read More

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Case report: Challenging post-traumatic pseudoarthrosis of C2 odontoid fracture and extreme C1-C2 subluxation.

Surg Neurol Int 2022 8;13:137. Epub 2022 Apr 8.

Department of Neurosurgery, Centro Hospitalar Universitário do Algarve, Faro, Portugal.

Background: Type II C2 odontoid fractures are common traumatic cervical spine lesions and have the highest risk of non-union without fusion. Pseudoarthrosis may lead to extreme anatomic deformation, and poor clinical outcomes. A 50-year-old male, following a traumatic C2 dens fracture treated when the patient was 44 years of age, newly presented at age 50 with pseudoarthrosis and severe C1-C2 subluxation that required a secondary fusion using a three-dimensional (3D) printed model for appropriate surgical planning. Read More

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[Fixation of anterior pelvic ring fracture with long reconstruction plate combined with MIPPO technique].

Zhongguo Gu Shang 2022 Apr;35(4):328-32

Department of Traumatic Orthopaedics, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China.

Objective: To evaluate the efficacy of long reconstruction plate combined with minimally invasive percutaneous plate osteosynthesis(MIPPO) technique in the treatment of unstable pelvic anterior ring fractures.

Methods: From January 2013 to February 2019, 16 patients with unstable pelvic fracture were treated, including 12 males and 4 females, aged from 20 to 60 years(mean 46.5 years). Read More

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[Intraoperative assisted O-arm navigation imaging for unstable pelvic fractures in INFIX].

Zhongguo Gu Shang 2022 Apr;35(4):317-22

The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China.

Objective: To investigate the effect of internal external fixator assisted O-arm navigation imaging in the treatment of unstable pelvic fractures.

Methods: From May 2019 to November 2019, 15 patients with unstable pelvic fractures were treated by intraoperative O-arm navigation imaging using INFIX technology. There were 6 males and 9 females. Read More

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Minimally Invasive Percutaneous TightRope® System Fixation for an Unstable Posterior Pelvic Ring: Clinical Follow-up and Biomechanical Studies.

Orthop Surg 2022 Apr 26. Epub 2022 Apr 26.

Department of Orthopaedics, First Hospital of Jilin University, Changchun, China.

Objective: To evaluate the mechanical stability and clinical efficacy of minimally invasive percutaneous TightRope® systems applied via gun-shaped reduction forceps for unstable posterior pelvic ring fractures.

Materials And Methods: This study consists of two parts: a clinical retrospective study and a randomized controlled biomechanical test. For the clinical study, a retrospective analysis of posterior pelvic ring fractures was performed between June 2015 and May 2020. Read More

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The Feasibility of Creating Image-Based Patient-Specific Drill Guides for the Atlantoaxial Instabilities Using Open-Source CAD Software and Desktop 3D Printers.

World Neurosurg 2022 Apr 4. Epub 2022 Apr 4.

Department of Neurosurgery, Ankara City Hospital, Ankara, Turkey.

Objective: C1/2 cervical pedicle screw fixation is a well-known procedure for treating severely damaged and unstable C1/2 fractures. On the other hand, C1/C2 screw fixation is not safe and can lead to potentially disastrous consequences. The importance of personalized 3-dimensional (3D) printed navigational guides in avoiding these consequences cannot be overstated. Read More

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Traumatic cervical spine spondyloptosis: A systematic review.

J Craniovertebr Junction Spine 2022 Jan-Mar;13(1):9-16. Epub 2022 Mar 9.

Department of Medicine, Faculty of Medicine, Algiers University, Algiers, Algeria.

Background: Spondyloptosis is a rare presentation of cervical spine traumatism where listhesis is more than 100%. Traumatic cervical spine spondyloptosis (TCS) is one of the least discussed forms of cervical spine traumatisms because of its rarity and the gravity of patient's condition, limiting good management, and the number of reported cases.

Objectives: This study aimed to discuss clinical, radiological, and best management tools of the aforementioned pathology. Read More

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Radiological Features in Type II Odontoid Fractures in Older Adults After High- and Low-Energy Trauma.

Global Spine J 2022 Mar 28:21925682221088215. Epub 2022 Mar 28.

Department of Neurosurgery, 9144Heidelberg University Hospital, Heidelberg, Germany.

Study Design: Retrospective study.

Objectives: Although type II odontoid fractures mainly occur due to high-energy trauma (HET), the number of odontoid type II fractures after low-energy trauma (LET) in the elderly is on the rise. However, there is a paucity of conclusive evidence on the relationship between trauma mechanism and cervical spine alignment in the elderly population. Read More

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Anti-Osteoporotic Effect of AR281 in an Ovariectomized Mouse Model Mediated by Inhibition of Osteoclast Differentiation.

Biology (Basel) 2022 Feb 24;11(3). Epub 2022 Feb 24.

School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China.

Osteoporosis is a global disease characterized by weakened bone microarchitecture, leading to osteoporotic fractures. Estrogen replacement therapy is the traditional treatment for osteoporosis but carries with it an increased risk of cardiac events. In search of a safe and effective treatment, we used AR281, which has anti-inflammatory properties, to conduct a 7-week experiment, investigating its inhibitory effects on osteoporosis in an ovariectomized (ovx) mouse model. Read More

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February 2022

Use of Intraoperative Imaging to Preserve C1-C2 Mobility in Complex Atlas-Hangman Fractures.

Neurol India 2022 Jan-Feb;70(1):209-214

Department of Neurosurgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Background: Combination fractures of the C1-C2 complex especially atlas and hangman are relatively uncommon and management usually compromises C1-C2 mobility.

Objective: To evaluate the treatment of combined C1- hangman's fracture with and without intraoperative O- arm based navigation system, and its outcome in terms of preserving C1-C2 mobility.

Methods: This was a case series of patients with combined C1 and hangman's fracture, managed at a tertiary care hospital during February 2009 to December 2016. Read More

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Nonoperative Management of Humerus Fractures in Patients With Ispilateral Hemiparesis or Hemiplegia.

Hand (N Y) 2022 Feb 21:15589447211073835. Epub 2022 Feb 21.

Mayo Clinic, Rochester, MN, USA.

Background: Patients with upper limb dysfunction from a brain injury often have different goals of treatment and expectations following a fracture of the upper extremity. This study retrospectively reviewed outcomes of nonoperative management of acute humerus fractures in patients with severe ipsilateral hemiparesis or hemiplegia.

Methods: Patients who had sustained an acute humerus fracture managed nonoperatively, greater than 1 year following an upper motor neuron (UMN) injury resulting in ipsilateral severe hemiparesis or hemiplegia at a single tertiary care center from 1988 to 2019, were reviewed. Read More

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February 2022

Direct Internal Fixation for Unstable Atlas Fractures.

Yonsei Med J 2022 Mar;63(3):265-271

Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Purpose: To investigate the radiologic and clinical outcomes of direct internal fixation for unstable atlas fractures.

Materials And Methods: This retrospective study included 12 patients with unstable atlas fractures surgically treated using C1 lateral mass screws, rods, and transverse connector constructs. Nine lateral mass fractures with transverse atlantal ligament (TAL) avulsion injury and three 4-part fractures with TAL injury (two avulsion injuries, one TAL substance tear) were treated. Read More

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C1-ring osteosynthesis versus C1-2 fixation fusion in the treatment of unstable atlas fractures: a multicenter, prospective, randomized controlled study with 5-year follow-up.

J Neurosurg Spine 2022 Feb 11:1-9. Epub 2022 Feb 11.

6Department of Spine Surgery, General Hospital of Pingmei Shenma Group, Pingdingshan, China.

Objective: The aim of the present study was to compare the long-term effects of posterior C1-ring osteosynthesis and C1-2 fixation fusion in the treatment of unstable atlas fractures.

Methods: A multicenter, prospective, randomized controlled trial was conducted to analyze 73 patients with atlas fractures who underwent posterior fixation. The intervention group was treated with C1-ring osteosynthesis, and the control group was treated with C1-2 fixation fusion. Read More

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February 2022

Fifty years later: the "rule of Spence" is finally ready for retirement.

J Neurosurg Spine 2022 Feb 11:1-8. Epub 2022 Feb 11.

Determination of the optimal approach to traumatic atlas fractures with or without transverse atlantal ligament (TAL) injury requires a nuanced understanding of the biomechanics of the atlantoaxial complex. The "rule of Spence" (ROS) was created in 1970 in a landmark effort to streamline management of burst-type atlas fractures. The ROS states that radiographic evidence of lateral mass displacement (LMD) (i. Read More

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February 2022

Tumor-Induced Osteomalacia With Normal Fibroblast Growth Factor-23 (FGF23) and Idiopathic Hypercalciuria.

Cureus 2022 Jan 3;14(1):e20893. Epub 2022 Jan 3.

Department of Neurology, Hospital General de Mexico Dr. Eduardo Liceaga, Mexico City, MEX.

Tumor-induced osteomalacia (TIO) is a rare acquired paraneoplastic syndrome characterized by low serum phosphate, phosphaturia, inappropriately low/normal levels of serum calcitriol, and normal or elevated levels of fibroblast growth factor-23 (FGF23). Finding this mesenchymal tumor is challenging since it is usually benign, small, slow-growing, and is localized in the appendicular skeleton. We report a 58-year-old male patient who arrived at the endocrinology outpatient clinic due to slowly progressive low back pain and generalized weakness since the age of 48. Read More

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January 2022

Immediate Full Weight-Bearing Versus Partial Weight-Bearing After Plate Fixation of Distal Femur Fractures in Elderly Patients. A Randomized Controlled Trial.

Geriatr Orthop Surg Rehabil 2021 6;12:21514593211055889. Epub 2021 Dec 6.

Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden.

Introduction: After surgery for distal femur fractures in elderly patients, weight-bearing is commonly restricted. Immediate non-restrictive weight-bearing might have beneficial effects. There are no randomized studies on the topic. Read More

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December 2021

Treatment of C1.1 (AO-41) tibial plateau fracture: A finite element analysis of single medial, lateral and dual plating.

Exp Ther Med 2022 Mar 5;23(3):198. Epub 2022 Jan 5.

Department of Surgery II, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.

Bicondylar tibial plateau fractures pose many challenges in surgical treatment. The aim of the present study was to analyze three methods of reduction, single medial, single lateral, and dual plating, for the treatment of a bicondylar tibial plateau fracture, through finite element analysis (FEA). A simple metaphyseal fracture, type C1. Read More

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Unilateral C1 split fracture osteosynthesis using a patient-specific three-dimensional-printed guide: Technique report.

J Craniovertebr Junction Spine 2021 Oct-Dec;12(4):437-439. Epub 2021 Dec 11.

Department of Medical Physics, Hospital Privado de Rosario, Santa Fe, Argentina.

Split-type C1 lateral mass fractures have a propensity for progressive fracture displacement. Since almost all cases end up showing progressive fragment diastasis, many authors recommend early surgical treatment. However, placing a C1 lag screw through a C1 split fracture is a challenging task. Read More

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December 2021

Tumoral Calcinosis of the Cervical Spine Associated with a Pathologic Odontoid Fracture.

Case Rep Neurol Med 2022 7;2022:2798490. Epub 2022 Jan 7.

Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA.

Tumoral calcinosis involves focal calcium deposits in the soft tissues surrounding a joint and most commonly occurs in the hips and elbows, rarely in the cervical spine. Furthermore, it has not been known to be associated with pathologic fractures. To the best of our knowledge, our case report highlights the first case of a pathologic type II odontoid fracture associated with adjacent tumoral calcinosis, resulting in pain, dysphagia, and severe spinal stenosis. Read More

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January 2022

Displaced posterior pelvic ring fractures treated with an unlocking closed reduction technique: Prognostic factors associated with closed reduction failure, reduction quality, and fixation failure.

Injury 2022 Jan 5. Epub 2022 Jan 5.

Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. Electronic address:

Purposes: This study aimed to evaluate the clinical effect of the unlocking closed reduction technique (UCRT) for the displaced posterior pelvic ring fractures and to analyze the factors associated with failure of closed reduction and fixation.

Patients And Methods: Data from patients admitted with displaced posterior pelvic ring fractures initially treated with the URCT from July 2017 to January 2020 were extracted. Clinical and radiological factors including fracture classification, interval days from injury to surgery, number of screws, and type of fixation for the posterior pelvic ring were analyzed to evaluate their correlation with closed reduction failure, reduction quality, and fixation failure. Read More

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January 2022

Clinical Analysis of Single and Double Sacroiliac Screws in the Treatment of Tile C1 Pelvic Fracture.

Biomed Res Int 2022 4;2022:6426977. Epub 2022 Jan 4.

Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000 Shaanxi, China.

We investigated the difference between fixation of single and double sacroiliac screws in the treatment of Tile C1 pelvic fractures. The data of 54 patients with Tile C1 pelvic fractures who were admitted to the trauma center of the Red Society Hospital Affiliated to Xi'an Jiaotong University between August 2016 and August 2020 were retrospectively analyzed. All patients with posterior pelvic ring injuries underwent fixation with sacroiliac screws assisted by a percutaneous robotic navigation system. Read More

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January 2022

Cervical spine injury response to direct rear head impact.

Clin Biomech (Bristol, Avon) 2022 02 17;92:105552. Epub 2021 Dec 17.

International Laboratory on Spine Imaging and Biomechanics, France and Canada; Laboratoire de Biomécanique Appliquée-Université Gustave-Eiffel, Aix-Marseille Université, UMR T24, 51 boulevard Pierre Dramard, 13015 Marseille, France.

Background: Direct rear head impact can occur during falls, road accidents, or sports accidents. They induce anterior shear, flexion and compression loads suspected to cause flexion-distraction injuries at the cervical spine. However, post-mortem human subject experiments mostly focus on sled impacts and not direct head impacts. Read More

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February 2022

Distal Radial Fracture Fixation in Adults using Intramedullary Elastic Wires Augmented with either Cast Immobilisation or External Fixation.

Malays Orthop J 2021 Nov;15(3):36-44

Research and Development, Jawrani MedTECH Consulting, Mumbai, India.

Introduction: The aim of this study was to evaluate the clinical outcomes following treatment of distal radial fractures using intramedullary elastic wires with a combination of either cast immobilisation or external fixation.

Materials And Methods: A total of 42 patients (24 females and 18 males) aged 40 to 78 years who presented with displaced and unstable, closed or grade I open, extra- and/or intra-articular fractures of the distal radius were included in the study. Twenty-seven fractures were AO/OTA Type A2-A3 and 15 Type C1-C2. Read More

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November 2021

Does Cement Augmentation of the Sacroiliac Screw Lead to Superior Biomechanical Results for Fixation of the Posterior Pelvic Ring? A Biomechanical Study.

Medicina (Kaunas) 2021 Dec 16;57(12). Epub 2021 Dec 16.

Department for Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, Waldeyerstraße 1, 48149 Münster, Germany.

: The stability of the pelvic ring mainly depends on the integrity of its posterior part. Percutaneous sacroiliac (SI) screws are widely implanted as standard of care treatment. The main risk factors for their fixation failure are related to vertical shear or transforaminal sacral fractures. Read More

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December 2021

Bilateral triceps tendon approach is flexible and efficient in the treatment of type C distal humerus fractures.

Chin J Traumatol 2022 May 9;25(3):145-150. Epub 2021 Dec 9.

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated No.6 People's Hospital, Shanghai, 200233, China. Electronic address:

Purpose: The purpose of this study was to assess and compare elbow range of motion, triceps extension strength and functional results of type C (AO/OTA) distal humerus fractures treated with bilateral triceps tendon (BTT) approach and olecranon osteotomy (OO). At the same time, we are also trying to know whether BTT approach can provide sufficient vision for comminuted intra-articular fractures of the distal humerus, and whether it is convenient to convert to the treatment to total elbow arthroplasty (TEA) or OO.

Methods: Patients treated with OO and BTT approaches for type C distal humerus fractures between July 2014 and December 2017 were retrospectively reviewed. Read More

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