Objective: The objective of this study was to compare perioperative, clinical parameters, complications, and reoperation rate of the Gallie technique and head-neck-chest plaster with the Harms technique in the treatment of odontoid fractures.
Design: A retrospective study.
Setting: Level I spine center.
Patients: Fifty-seven patients with odontoid fractures treated either with the Gallie technique and casting or the Harms technique between July 2002 and June 2008.
Intervention: Surgery.
Main outcome measurements: At a minimum of 2-year follow-up, comparison of the two groups was conducted in terms of hospital stay, blood loss, operation time, cost of the first admission, total cost, time to fusion, time to return to previous occupation, Japanese Orthopedic Association scores, visual analog scale scores of neck pain, complications (nonunion, delayed union, hardware breakage, wound infection), and reoperation rate.
Results: There were no significant differences in terms of hospital stay, time to fusion, Japanese Orthopedic Association scores, neck pain visual analog scale scores, complications, or reoperation rate between the two groups. Blood loss, operation time, cost of the first admission, and total cost were significantly lower in the Gallie group than that in the Harms group. However, the Gallie group took longer to return to previous occupation than the Harms group (P < 0.001).
Conclusions: Management of odontoid fractures by either the Gallie technique and casting or the Harms technique was found to be similar in clinical outcomes. Although the Harms technique was associated with more blood loss, operation time, and cost, the Harms technique was found to be superior to the Gallie technique with casting in terms of time to return to previous occupation.