From the Research
Type III dens fractures should be treated with odontoid screw fixation (OSF) as it is a reliable method with a high bone fusion rate and minimal risk of complications, as shown in the most recent study from 2024 1.
Treatment Options
The treatment of type III dens fractures is crucial to prevent serious neurological complications. The options include:
- Surgical fixation: anterior odontoid screw fixation or posterior C1-C2 fusion
- External immobilization: rigid cervical collar or halo vest
Recommendation
Based on the most recent and highest quality study from 2024 1, odontoid screw fixation (OSF) is the recommended treatment for type III dens fractures, especially for patients with fragment displacement of 4 mm or less. This method has a high bone fusion rate of 95.7% and minimal risk of complications.
Key Considerations
- Early diagnosis through CT imaging is essential to determine the best course of treatment
- Patients with significant displacement (>5mm) or angulation (>10 degrees) may require surgical intervention
- Elderly patients or those with compromised conditions may be considered for non-surgical management with a rigid cervical collar or halo vest, as shown in a study from 2001 2
- The degree of dens fragment displacement is a significant factor in determining the risk of screw cut-out, as observed in a study from 2024 1