Risk factors of non-union in Anderson-D'Alonzo type III odontoid fractures with conservative treatment

Hiroyuki Koshimizu; Hiroaki Nakashima; Keigo Ito; Kei Ando; Kazuyoshi Kobayashi; Fumihiko Kato; Koji Sato; Masao Deguchi; Yuji Matsubara; Hidenori Inoue; Tokumi Kanemura; Tetsuya Urasaki; Hisatake Yoshihara; Norimitsu Wakao; Ryuichi Shinjo; Shiro Imagama

doi:10.1016/j.jor.2021.03.012

Risk factors of non-union in Anderson-D'Alonzo type III odontoid fractures with conservative treatment

J Orthop. 2021 Mar 29:24:280-283. doi: 10.1016/j.jor.2021.03.012. eCollection 2021 Mar-Apr.

Authors

Hiroyuki Koshimizu^{1

2}, Hiroaki Nakashima^{1

2}, Keigo Ito^{3

2}, Kei Ando^{1

2}, Kazuyoshi Kobayashi^{1

2}, Fumihiko Kato^{3

2}, Koji Sato^{4

2}, Masao Deguchi^{5

2}, Yuji Matsubara^{6

2}, Hidenori Inoue^{7

2}, Tokumi Kanemura^{8

2}, Tetsuya Urasaki^{9

2}, Hisatake Yoshihara^{10

2}, Norimitsu Wakao^{11

2}, Ryuichi Shinjo^{12

2}, Shiro Imagama^{1

2}

Affiliations

¹ Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
² Nagoya Spine Group, Japan.
³ Department of Orthopaedic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan.
⁴ Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi, Japan.
⁵ Department of Orthopaedic Surgery, Nagano Red Cross Hospital, Nagano, Nagano, Japan.
⁶ Department of Orthopaedic Surgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan.
⁷ Department of Orthopaedic Surgery, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Aichi, Japan.
⁸ Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Aichi, Japan.
⁹ Department of Orthopaedic Surgery, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan.
¹⁰ Department of Orthopaedic Surgery, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan.
¹¹ Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
¹² Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Aichi, Japan.

Abstract

Objective: The purpose of this study was retrospectively to analyze the risk factors for non-union in Anderson-D'Alonzo type III odontoid fractures with conservative treatment.

Methods: 25 patients with type III fractures were analyzed. Coronal and sagittal tilt as well as sagittal and lateral mass gaps were measured by using computed tomography.

Results: The non-union group had significantly higher age, greater coronal tilt and lateral mass gap. Especially, the lateral mass gap was >2 mm in all cases with non-union.

Conclusions: Higher age, coronal tilt, and lateral mass gap were significant risk factors for non-union.

Keywords: Anderson–D’Alonzo type III odontoid Fractures; Conservative treatment; Non-union; Risk factors.