Background Data: Traumatic Odontoid Epiphysiolysis fractures, although rare in the overall incidence of spinal trauma, these fractures are one of the common fractures in young children. The appropriate treatment of this type of odontoid fractures remains controversial. The rarity of literature reports on these fractures and limited number of cases prevented the consensus on the optimal line of treatment. Purpose: To clarify the role of non-operative treatment in this type of fracture and ascertain its beneficial role in reaching sound fusion.
Study Design: Prospective assessment of Traumatic Odontoid Epiphysiolysis in young child with literature review.
Patients and Methods: A 4 years female child developed Traumatic Odontoid Epiphysiolysis after falling downstairs. The child was neurologically intact with severe neck pain and spasm. On examination apparent neck spasm and limitation of movement was noticed. The patient was managed by non-operative treatment. External immobilization using Minerva orthosis for 12 weeks was conducted under fluoroscopy to ascertain optimum position. The patient was followed up clinically and radiologically for 3 months. Literature review of series reporting children with Traumatic Odontoid Epiphysiolysis fractures was also conducted.
Results: Realignment and sound fusion was obtained after 12 weeks. The patient remained neurologically intact. Neck pain and limitation of movement improved after removal of the external fixation. As regard literature review, 105 cases were reported with Traumatic Odontoid Epiphysiolysis fractures, external immobilization was done successfully in 87%,
and surgical intervention using wiring or screws was done only in 13% of cases. Conclusion: Closed reduction and external fixation can be the primary treatment option for Traumati Odontoid Epiphysiolysis with high rate of fusion. (2018ESJ154)