Simultaneously, demographic changes have led to a dramatic increase of the elderly population in Europe. Improved motor vehicle safety and protective gear have reduced the incidence of spinal injuries in the younger population. Since C2 fracture types are associated with different fracture mechanisms, the distribution of various fracture types differ between younger and older patients. Ĭ2 fractures can be subdivided into odontoid fractures, Hangman's fractures, and atypical fractures. Due to a stiffer lower cervical spine, the aged upper cervical spine is susceptible to bony and ligamentous injuries, which-together with reduced bone density-explains the disproportionally high proportion of upper cervical injuries in elderly. Younger patients are more susceptible to high-energy trauma-related injuries, while elderly sustain bone density-related injuries. This finding is not uncommon among spinal fractures. The most common C2 fracture-the odontoid fracture-has a biphasic age distribution with peaks both at 20–30 and at 70–80 years of age. Knowledge of these proportions facilitates future epidemiological studies of C2 fractures.įractures of the second cervical vertebra (C2) are the most common cervical spinal injury among elderly. This study presents reliable subset proportions of C2 fractures in a prospectively collected regional cohort. 40% of C2 fractures were treated surgically. There was an increasing incidence of odontoid fractures types 2 and 3 from 2002 to 2014. In the geriatric subgroup 89% of all C2 fractures were odontoid, of which 71% were type 2 and 29% type 3. Odontoid fractures were found in 183 patients, of which 2 were type 1, 127 type 2, and 54 type 3, while 26 of C2 fractures were Hangman's fractures and 24 were atypical C2 fractures. 233 patients (female 51%, age 72 ± 19 years) were treated for a C2 fracture. C2 fractures were classified into odontoid fractures types 1, 2, and 3, Hangman's fractures types 1, 2, and 3, and atypical C2 fractures. A dataset of all patients treated between 20 for C2 fractures was extracted from the regional hospital information system. This study was designed to identify the proportions of the second cervical vertebra (C2) fracture subtypes and to present age and gender specific incidences of subgroups. The currently available data on the distribution of C2 fracture subtypes is sparse. Fractures of the Ankle Joint: Investigation and Treatment Options. Goost H, Wimmer M, Barg A, Kabir K, Valderrabano V, Burger C. Evaluation of the Syndesmotic-Only Fixation for Weber-C Ankle Fractures with Syndesmotic Injury. CURRENT Diagnosis & Treatment in Orthopedics, Fourth Edition. Musculoskeletal Eponyms: Who Are Those Guys? Radiographics. It was later modified and popularized by the Swiss orthopedic surgeon, Bernhard Georg Weber (1929-2002), in 1972 2. This classification was first described by the Belgian general surgeon, Robert Danis (1880-1962), in 1949. Usually associated with an injury to the medial side Weber C fractures can be further subclassified as 6Ĭ1: diaphyseal fracture of the fibula, simpleĬ2: diaphyseal fracture of the fibula, complexĪ fracture above the syndesmosis results from external rotation or abduction forces that also disrupt the joint Medial malleolus fracture or deltoid ligament injury often presentįracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs ( Maisonneuve fracture) Tibiofibular syndesmosis disruption with widening of the distal tibiofibular articulation Weber B fractures could be further subclassified as 9ī2: associated with a medial lesion (malleolus or ligament)ī3: associated with a medial lesion and fracture of posterolateral tibiaĪbove the level of the syndesmosis (suprasyndesmotic) Variable stability, dependent on the status of medial structures (malleolus/ deltoid ligament) and syndesmosis may require open reduction and internal fixation (ORIF) Tibiofibular syndesmosis usually intact, but widening of the distal tibiofibular joint (especially on stressed views) indicates syndesmotic injuryĭeltoid ligament may be torn, indicated by widening of the space between the medial malleolus and talar dome Usually stable if medial malleolus intact treat with CAM Walker or Moon Boot with crutches and weight bear as tolerated with them for 6 weeksĭistal extent at the level of the syndesmosis (trans-syndesmotic) may extend some distance proximally Below the level of the syndesmosis (infrasyndesmotic)
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |