Original research articleTreatment of the dens fractures in children
Section snippets
Background
Upper cervical spine injuries are associated with high energy and are frequently fatal. Children appear to be at increased risk of injury at this site [[1], [2], [3], [4]]. The injury frequently leads to severe cord and brain-stern injury, causing respiratory arrest. Increasingly, however, there have been reports of patients surviving this injury and even patients with upper cervical fractures with intact neurological function have been documented [5]. 2–3% of all cervical spinal injuries are
Material and method
From 2000 to 2016, 10 patients with C2 dens fractures were treated. It is a retrospective work consisting in the data analysis of the dens fractures treatment in children, the approval of the ethical committee was not required for this study. The parents have been informed that their child's disease will be included in scientific paper. There were 3 boys and 7 girls. The mean age was 11 years (3–17).
The fractures were caused by a traffic accident in 4 of the cases, a fall in 3 cases and sport
Results
The follow up was 78 months (12–180). If the child had no neck pain or cervical spine tenderness and had a full, painless range of motion of the neck and spine, then the cervical brace orthosis was removed. The patient’s range of motion was evaluated only when they were conscious and cooperative. After ablation of the brace, anteroposterior and lateral radiographs with voluntary flexion and extension of the cervical spine were used in 9 patients (1 patient being a non-cooperative patient).
Discussion
Children with injuries to the cervical spine present a great challenge for medical facilities. In addition, a child presents challenges in assessment, imaging, and both operative and nonoperative management [4]. There are very few papers about pediatric C2 dens fractures, especially fractures with no neurological deficit. The goal of the C2 dens fracture is the return of maximum functional ability, minimal residual pain, decrease of any neurological deficit, minimal residual deformity and
Conclusion
- 1
The C2 dens fracture rarely occurs in children.
- 2
The diagnostic method for C2 dens is CT-scan, MRI and X-ray evaluation.
- 3
The classification system of dens fractures developed by Anderson is useful in choosing the mode of treatment of the dens fractures.
- 4
The Halo-Vest is a good method for treating unstable C2 dens fractures.
Conflict of interest
None declared.
Acknowledgement and financial support
None declared.
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2022, European Journal of Trauma and Emergency Surgery