Reduction and stabilization of displaced type II odontoid fractures in young adults – A case series of four patients utilizing different operative techniques

Introduction:Odontoid fractures are one of the most common injuries to the cervical spine. Type II odontoid fracture treatment varies depending on age, co-morbidities, and fracture morphology. Treatment ranges from cervical orthosis to surgical intervention. Currently fractures with high non-union rates are considered for operative management which includes displacement of >6 mm, increasing age (>40-60 years), fracture gap >1 mm, delay in treatment >4 days, posterior re-displacement >2 mm, increased angulation, and history of smoking. While re-displacement of >2 mm has been associated with increased risk of non-union;, to the best of our knowledge, no studies have looked at the risk factors for re-displacement. Case Report:We present two 26-year-old male patients who were found to have minimally displaced type II odontoid fractures initially treated in a cervical collar. These two patients were subsequently found to have displaced their odontoid fracture after having a documented seizure. Conclusion:We suggest that a history of seizures be considered a risk factor for re-displacement of non-displaced type II odontoid fractures. Keywords:Operative indications odontoid case report, Type II odontoid fracture, Displacement, Seizure, Odontoid fracture displacement, Nondisplaced type ? odontoid fracture.

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Management of acute odontoid fractures: operative techniques and complication avoidance

Neurosurgical FOCUS ◽

10.3171/foc.2000.8.6.4 ◽

2000 ◽

Vol 8 (6) ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Shushil Shilpakar SK ◽

Mark R. McLaughlin ◽

Regis W. Haid ◽

Gerald E. Rodts ◽

Brian R. Subach

Keyword(s):

Selection Criteria ◽

Screw Fixation ◽

Acute Type ◽

Type Ii ◽

Success Rates ◽

Transverse Ligament ◽

Operative Techniques ◽

Chronic Type ◽

Odontoid Fractures ◽

Ligament Disruption

In this article the authors describe the management of Type II odontoid fractures with special attention to operative technique and avoidance of complication. Anterior odontoid screw fixation is a procedure the authors have performed over the last 8 years in cases with acute Type II and rostral Type III odontoid fractures. In cases of Chronic Type II odontoid fractures and in patients with transverse ligament disruption, the authors prefer to undertake posterior transarticular facet screw fixation supplemented by bone graft and interspinous C1–2 wiring. The technical aspects of these procedures are described with a focus on operative nuances. Selection criteria and techniques that the authors have refined over the years have helped them to optimize success rates and minimize complications.

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Endoscopically-Assisted Percutaneous Unilateral Atlantoaxial Screw-Rod Nonfusion Fixation Treatment for Type II Odontoid Fractures in Geriatric Patients: Case Series and Technical Note

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/e241 ◽

2020 ◽

Vol 2;23 (4;2) ◽

pp. E241-E250

Author(s):

Zhong-Liang Deng

Keyword(s):

Geriatric Patients ◽

Spinal Injury ◽

Neck Disability Index ◽

Case Series ◽

Optimal Treatment ◽

Bone Union ◽

Full Time ◽

Type Ii ◽

Odontoid Fractures ◽

Increased Risk

Background: Considerable controversy exists regarding the optimal treatment for type II odontoid fractures in geriatric patients. Surgical intervention can help patients return to their prior level of function as rapidly as possible while avoiding the morbidity and mortality associated with prolonged and bedbound hospitalization. However, the optimal treatment is still a difficult choice for patients with increased risk from anesthesia. Objectives: The objective of our study was to describe an innovative method of endoscopically-assisted percutaneous unilateral C1 lateral mass screw and C2 pedicle screwrod nonfusion fixation for type II odontoid fractures in geriatric patients. Study Design: A case series design and technical notes. Setting: This study took place at Second Affiliated Hospital of Chongqing Medical University. Methods: Seven geriatric patients (> 65 years) with type II odontoid fractures and an American Society of Anesthesiologists (ASA) score of 2 or higher received endoscopicallyassisted percutaneous unilateral atlantoaxial screw-rod nonfusion fixation. After surgery, all patients were required to wear a rigid collar full-time for 12 weeks. Intraoperative data, the bone union time, American Spinal Injury Association (ASIA) scale scores, Neck Disability Index (NDI) scores, and postoperative complications were collected for assessment. Results The surgical goal was successfully achieved in all patients, 3 of whom had high ASA scores (≥3) and underwent surgery under local anesthesia. The operative time ranged from 112 to 169 minutes (mean, 131.1 minutes). No neurovascular complications were observed intraoperatively or postoperatively. All patients rapidly returned to their prior level of function and were followed up for 12 to 24 months (average: 16.9 months). Bone union was achieved in all patients. Limitations: This study is limited by being a retrospective study. Conclusions: Endoscopically-assisted percutaneous unilateral atlantoaxial screw-rod nonfusion fixation is a feasible technique for type II odontoid fractures in geriatric patients. This method offers a compromise between non-operative and operative treatment and allows geriatric patients to rapidly return to their prior level of function. Key words: Endoscopically-assisted surgery; geriatric patient; percutaneous atlantoaxial fixation; type II odontoid fracture; unilateral nonfusion fixation

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Epidemiological study of open fractures of the ankle and foot

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2021.v15.1545 ◽

2021 ◽

Vol 15 (2) ◽

pp. 150-154

Author(s):

Leandro Pessoa Carneiro ◽

Luiz Augusto Sampaio Gonzaga Filho ◽

Jorge Mizusaki ◽

Sergio Prata ◽

Marco Rizzo

Keyword(s):

Young Adults ◽

Elementary Education ◽

Medical Records ◽

Case Series ◽

Sao Paulo ◽

Open Fractures ◽

Type Ii ◽

São Paulo ◽

Hospital Service ◽

Ankle And Foot

Objective: To characterize the epidemiological profile of patients treated at a hospital service with diagnosis of open fracture of the ankle and foot. Methods: Retrospective, descriptive, epidemiological, observational study of open fractures of the ankle and foot selected by convenience sampling in a hospital service in São Paulo, state of São Paulo, Brazil, from March 1, 2017, to March 1, 2019, totaling 109 patients. Data collection was conducted for the analysis of variables included in patients’ medical records. Results: The medical records of 700 patients with open fractures were assessed. Of these patients, 13.2% (109 patients) had open fractures of the ankle and foot. There was a predominance of male young adults (70.8%) and of left lower limb fractures (51.85%). Most cases were classified as Gustilo and Anderson type II fractures (42.6%). Motorcycle accidents (44.45%) predominated, and students and professional motorcyclists were the most frequent occupations (37.04%). The most adopted stabilization method was osteosynthesis (internal fixation) (44.45%), and primary amputation was required in 3.7% of the cases. Conclusion: Male young adults were the most affected by fractures of the ankle and foot, and traffic accidents were the leading cause. Most patients had an educational attainment of complete elementary education. Most fractures were classified as Gustilo and Anderson type II. Greater severity was observed in patients with associated injuries in other body segments and who developed early complications during hospitalization. Level of Evidence IV; Prognostic Studies; Case Series.

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Retrospective analysis of a case series of patients with traumatic injuries to the craniocervical junction

Einstein (São Paulo) ◽

10.1590/s1679-45082016ao3396 ◽

2016 ◽

Vol 14 (4) ◽

pp. 528-533

Author(s):

Luiz Adriano Esteves ◽

◽

Andrei Fernandes Joaquim ◽

Helder Tedeschi ◽

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Case Series ◽

Craniocervical Junction ◽

Data Sets ◽

Type Ii ◽

Surgical Wound ◽

Traumatic Injuries ◽

Odontoid Fractures ◽

Posterior Elements

ABSTRACT Objective To evaluate the correlation between the treatment, the characteristics of the lesions and the clinical outcome of patients with traumatic injuries to the craniocervical junction. Methods This was a retrospective study of patients treated conservatively or surgically between 2010 and 2013 with complete data sets. Results We analyzed 37 patients, 73% were men with mean age of 41.7 years. Of these, 32% were submitted to initial surgical treatment and 68% received conservative treatment. Seven (29%) underwent surgery subsequently. In the surgical group, there were seven cases of odontoid type II fractures, two cases of fracture of posterior elements of the axis, one case of C1-C2 dislocation with associated fractured C2, one case of occipitocervical dislocation, and one case of combined C1 and C2 fractures, and facet dislocation. Only one patient had neurological déficit that improved after treatment. Two surgical complications were seen: a liquoric fistula and one surgical wound infection (reaproached). In the group treated conservatively, odontoid fractures (eight cases) and fractures of the posterior elements of C2 (five cases) were more frequent. In two cases, in addition to the injuries of the craniocervical junction, there were fractures in other segments of the spine. None of the patients who underwent conservative treatment presented neurological deterioration. Conclusion Although injuries of craniocervical junction are relatively rare, they usually involve fractures of the odontoid and the posterior elements of the axis. Our results recommend early surgical treatment for type II odontoid fractures and ligament injuries, the conservative treatment for other injuries.

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The effect of fatigue in hip abductor muscles on balance in healthy young adults: a preliminary case series

Gazzetta Medica Italiana Archivio per le Scienze Mediche ◽

10.23736/s0393-3660.17.03687-7 ◽

2018 ◽

Vol 177 (12) ◽

Cited By ~ 1

Author(s):

Metehan Yana ◽

İsmail Saraçoğlu ◽

Yusuf Emuk ◽

Ozge K. Yenilmez

Keyword(s):

Young Adults ◽

Case Series ◽

Hip Abductor

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Total laparoscopic transabdominal-transdiaphragmatic approach for treating Siewert II tumors: a prospective analysis of a case series

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02136-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Wei Pang ◽

Gang Liu ◽

Yan Zhang ◽

Yun Huang ◽

Xinpu Yuan ◽

...

Keyword(s):

Surgical Approach ◽

Mediastinal Lymph Node ◽

Intraoperative Complications ◽

Case Series ◽

Type Ii ◽

Clinical Trial Registry ◽

Siewert Type ◽

Siewert Type Ii ◽

Estimated Blood Loss ◽

Gastrointestinal Reconstruction

Abstract Background Although the morbidity of gastric cancer has decreased, the incidence of adenocarcinoma of the esophagogastric junction (AEG) is increasing. Furthermore, no consensus exists on which surgical approach should be applied for Siewert type II AEG. The purpose of our study was to evaluate the technical safety and feasibility of a new surgical approach. Methods Sixty patients with Siewert type II AEG underwent laparoscopic total gastrectomy with the total laparoscopic transabdominal-transdiaphragmatic (TLTT) approach, which needs an incision in the diaphragm. Results The median operative time, reconstruction time, and estimated blood loss were 214.8 ± 41.6 min, 29.40 ± 7.1 min, and 209.0 ± 110.3 ml, respectively. All of the patients had negative surgical margins. Conclusion There were no intraoperative complications or conversions to open surgery. Our surgical procedure provides a unique option for the safe application of laparoscopic lower mediastinal lymph node dissection and gastrointestinal reconstruction. Trial registration Chinese Clinical Trial Registry, ChiCTR1800014336. Registered on 31 December 2017 - Prospectively registered, http://www.chictr.org.cn/edit.aspx?pid=23111&htm=4.

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Clinical and radiological outcomes of acetabular revision surgery with trabecular titanium cups in Paprosky type II and III bone defects

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00571-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Loris Perticarini ◽

Stefano Marco Paolo Rossi ◽

Marta Medetti ◽

Francesco Benazzo

Keyword(s):

Revision Surgery ◽

Case Series ◽

Bone Defects ◽

Harris Hip Score ◽

Type Ii ◽

Level Of Evidence ◽

Kaplan Meier ◽

Prospective Case Series ◽

Acetabular Components

Abstract Background This prospective study aims to evaluate the mid-term clinical outcomes and radiographic stability of two different types of cementless trabecular titanium acetabular components in total hip revision surgery. Methods Between December 2008 and February 2017, 104 cup revisions were performed using trabecular titanium revision cups. Mean age of patients was 70 (range 29–90; SD 11) years. The majority of revisions were performed for aseptic loosening (86 cases, 82.69%), but in all the other diagnoses (18 cases), a significant bone loss (Paprosky type II or III) was registered preoperatively. Bone defects were classified according to Paprosky acetabular classification. We observed 53 type II defects and 42 type III defects. Cups were chosen according to the type of defect. Results Average follow-up was 91 (range 24–146) months. Mean Harris Hip Score (HHS) improved from 43.7 (range 25–70; SD 9) preoperatively to 84.4 (range 46–99; SD 7.56) at last follow-up. One (1.05%) cup showed radiographic radiolucent lines inferior to 2 mm and was clinically asymptomatic. One (1.05%) cup was loose and showed periacetabular allograft reabsorption. Kaplan–Meier survivorship was assessed to be 88.54% (95% CI 80.18–93.52%) at 71 months, with failure of the cup for any reason as the endpoint. Conclusion Trabecular titanium revision cups showed good clinical and radiographic results at mid-term follow-up in Paprosky type II and III bone defects. Level of evidence Level IV prospective case series

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Psychotic disorders in young adults with perinatally acquired HIV: a UK case series

Psychological Medicine ◽

10.1017/s0033291720004134 ◽

2020 ◽

pp. 1-7

Author(s):

I. Mallik ◽

T. Pasvol ◽

G. Frize ◽

S. Ayres ◽

A. Barrera ◽

...

Keyword(s):

Mental Health ◽

Young Adults ◽

Young People ◽

Case Series ◽

Psychotic Episode ◽

Published Data ◽

Growing Up ◽

Term Care ◽

Perinatally Acquired

Abstract Background Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV. Methods We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184). Results In total, 12/184 (6.5%), median age 23 years (interquartile range 21–26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care. Conclusion The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16–34 years, which has been reported to be 0.5–1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.

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