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Erschienen in: Child's Nervous System 11/2013

01.11.2013 | Case Report

Sequential imaging demonstrating os odontoideum formation after a fracture through the apical odontoid epiphysis: case report and review of the literature

verfasst von: Ian K. White, Kevin J. Mansfield, Daniel H. Fulkerson

Erschienen in: Child's Nervous System | Ausgabe 11/2013

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Abstract

Introduction

The mechanism of formation of an os odontoideum is controversial and likely multifactorial. One theory states that the apex of the odontoid separates from the body because of a fracture. The intact alar and apical ligaments pull the fractured segment superiorly. The independent vascular supply of the apex allows the fractured bone to remain viable and remodel into the smooth, corticated bone characteristic of an os odontoideum. However, there are no publications with direct radiographic evidence supporting the theory.

Case report

In this paper, the authors present a 7-year-old child with a fracture through the apical odontoid epiphysis, extending into the body of the dens. Serial imaging studies demonstrate progressive separation of the apex from the body of the odontoid. The fractured segment begins to remodel and assume the classic form of an os.

Conclusion

The authors consider this case to be radiographic evidence supporting an acquired/traumatic origin of os odontoideum. Further, the mechanism of fracture through a cartilaginous epiphysis may explain the formation of an os after “normal” x-ray images or following seemingly minor trauma.
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Metadaten
Titel
Sequential imaging demonstrating os odontoideum formation after a fracture through the apical odontoid epiphysis: case report and review of the literature
verfasst von
Ian K. White
Kevin J. Mansfield
Daniel H. Fulkerson
Publikationsdatum
01.11.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 11/2013
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-013-2132-6

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