3 An 84-year-old man fell and sustained a type II odontoid fracture. He then had a Gallie fusion. A halo vest was placed postoperatively, but a year later he still had nonunion. Translational instability was noted on dynamic x-ray. He is neurologically intact but uses a walker to guard against falls. FIGURE 3-1 Preoperative cervical x-ray with nonunion. Cervical x-ray demonstrating type II C2 fracture with evidence of graft resorption is seen in Fig. 3-1. Nonunion The posterior C1-C3 fusion was redone using a Ti frame (Codman, Raynham, Massachusetts) and sublaminar wiring (Fig. 3-2), as well as an iliac crest structural autograft, followed by a halo for 3 to 4 months.
Nonunion of a Type II Odontoid Fracture
Presentation
Radiologic Findings
Diagnosis
Treatment
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