scholarly journals Oblique Axis Body Fracture: An Unstable Subtype of Anderson Type III Odontoid Fractures—Apropos of Two Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Hirokazu Takai ◽  
Lukas Konstantinidis ◽  
Hagen Schmal ◽  
Peter Helwig ◽  
Stefan Knöller ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Fracture Pattern ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Body Fracture ◽  
Type Fracture ◽  
Secondary Deformity ◽  
Axis Body ◽  
High Index Of Suspicion

Purpose. Anderson type III odontoid fractures have traditionally been considered stable and treated conservatively. However, unstable cases with unfavorable results following conservative treatment have been reported.Methods. We present the cases of two patients who sustained minimally displaced Anderson type III fractures with a characteristic fracture pattern that we refer to as “oblique type axis body fracture.”Results. The female patients aged 90 and 72 years, respectively, were both diagnosed with minimally displaced Anderson type III fractures. Both fractures had a characteristic “oblique type” fracture pattern. The first patient was treated conservatively with cervical spine immobilization in a semirigid collar. However, gross displacement was noted at the 6-week follow-up visit. The second patient was therefore treated operatively by C1–C3/4 posterior fusion and the course was uneventful.Conclusions. Oblique type axis body fractures resemble a highly unstable subtype of Anderson type III fractures with the potential of severe secondary deformity following conservative treatment, irrespective of initial grade of displacement. The authors therefore warrant a high index of suspicion for this injury and suggest early operative stabilization.

scholarly journals Patterns and prognosis of commotio retinae in orbital wall fractures

2019 ◽  
Vol 11 ◽  
pp. 251584141986213
Author(s):  
Halward M.J. Blegen ◽  
Joseph A. Santamaria ◽  
Aditya Mehta ◽  
Donovan S. Reed ◽  
Paul M. Drayna ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Fracture Pattern ◽  
Posterior Segment ◽  
Ocular Injury ◽  
Inferior Wall ◽  
Retinal Pathology ◽  
Orbital Wall ◽  
High Index Of Suspicion ◽  
Commotio Retinae

Purpose: Orbital wall fractures are a significant cause of ocular injury in trauma and are associated with posterior segment pathology. This study aims to characterize patterns and prognosis of commotio retinae following orbital wall fracture. Methods: This study is a retrospective analysis of 294 orbital wall fractures diagnosed by computed tomography imaging from August 2015 to October 2016 at a Level 1 trauma center. Dilated funduscopic exams were assessed for acute posterior segment pathology, focusing specifically on commotio retinae ( N = 38). These were compared with patients with no traumatic retinal findings ( N = 253) to indicate statistically significant differences in the mechanism of injury, fracture pattern, subjective symptoms, radiologic and exam findings, and acute interventions. Results: Commotio was most commonly associated with assault (60.5%, p = 0.004) in a younger patient population, whereas normal retinal exams were more likely after falls from standing (24.1%, p = 0.022). Half of all commotio was found inferiorly and most commonly occurred in medial or inferior wall fracture. Patients with commotio were more likely to have motility deficits (29.7%, p = 0.049) with clinical evidence of entrapment (13.2%, p < 0.001), requiring acute operative repair (15.8%, p = 0.005). Inferior wall fracture was associated with 19.4% surgical intervention in commotio as compared with those with normal funduscopic exams (6.1%, p = 0.012). All patients with follow-up had resolution of commotio and best-corrected visual acuity of 20/25 or better. Conclusion: Retinal pathology is not infrequent in orbital wall fractures. Inferior wall fracture was associated with 19.4% surgical intervention in commotio as compared to those with normal funduscopic exams (6.1%, p = 0.012). A high index of suspicion and thorough investigation is warranted in evaluating these patients.

scholarly journals Conservative treatment and follow-up of type III dens invaginatus using cone beam computed tomography

2014 ◽  
Vol 56 (4) ◽  
pp. 307-310 ◽  
Author(s):  
Kadir T. Ceyhanli ◽  
Davut Çelik ◽  
Subutay H. Altintas ◽  
Tamer Taşdemir ◽  
Ömer S. Sezgin
Keyword(s):  
Computed Tomography ◽  
Conservative Treatment ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Type Iii ◽  
Dens Invaginatus

Isolated Fractures of the Axis in Adults

Neurosurgery ◽  
2002 ◽  
Vol 50 (suppl_3) ◽  
pp. S125-S139 ◽  
Keyword(s):  
Treatment Guidelines ◽  
Type I ◽  
Type Ii ◽  
Insufficient Evidence ◽  
Treatment Standards ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Axis Body ◽  
Support Treatment ◽  
Traumatic Spondylolisthesis

Abstract RECOMMENDATIONS FRACTURES OF THE ODONTOID Standards There is insufficient evidence to support treatment standards. Guidelines Type II odontoid fractures in patients 50 years and older should be considered for surgical stabilization and fusion. Options Type I, Type II, and Type III fractures may be managed initially with external cervical immobilization. Type II and Type III odontoid fractures should be considered for surgical fixation in cases of dens displacement of 5 mm or more, comminution of the odontoid fracture (Type IIA), and/or inability to achieve or maintain fracture alignment with external immobilization. TRAUMATIC SPONDYLOLISTHESIS OF THE AXIS (HANGMAN's FRACTURE) Standards There is insufficient evidence to support treatment standards. Guidelines There is insufficient evidence to support treatment guidelines. Options Traumatic spondylolisthesis of the axis may be managed initially with external immobilization in most cases. Surgical stabilization should be considered in cases of severe angulation of C2 on C3 (Francis Grade II and IV, Effendi Type II), disruption of the C2–C3 disc space (Francis Grade V, Effendi Type III), or inability to establish or maintain alignment with external immobilization. FRACTURES OF THE AXIS BODY (MISCELLANEOUS FRACTURES) Standards There is insufficient evidence to support treatment standards. Guidelines There is insufficient evidence to support treatment guidelines. Options External immobilization is recommended for treatment of isolated fractures of the axis body.

Results of Long-Term Follow-Up in Patients Undergoing Anterior Screw Fixation for Type II and Rostral Type III Odontoid Fractures

Spine ◽  
2005 ◽  
Vol 30 (6) ◽  
pp. 661-669 ◽  
Author(s):  
Kostas N. Fountas ◽  
Eftychia Z. Kapsalaki ◽  
Ioannis Karampelas ◽  
Carlos H. Feltes ◽  
Vassilios G. Dimopoulos ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Anterior Screw Fixation ◽  
Long Term Follow Up

scholarly journals Risk factors of non-union in Anderson–D’Alonzo type III odontoid fractures with conservative treatment

2021 ◽  
Author(s):  
Hiroyuki Koshimizu ◽  
Hiroaki Nakashima ◽  
Keigo Ito ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conservative Treatment ◽  
Odontoid Fractures ◽  
Non Union ◽  
Type Iii

Conservative Treatment of Vestibular Schwannomas: A Follow-Up Study on Clinical Outcomes

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
M. Sadadcharam ◽  
R. Wormald ◽  
M. Javadpour ◽  
D. Rawluk ◽  
R. McConn-Walsh
Keyword(s):  
Conservative Treatment ◽  
Clinical Outcomes ◽  
Vestibular Schwannomas ◽  
Follow Up Study

A combined lateral-crestal approach of sinus floor elevation: A report on three cases

2020 ◽  
Author(s):  
Xin Zhang ◽  
Yuting Zhang ◽  
Jian Wang ◽  
Qianbing Wan ◽  
Lei Li
Keyword(s):  
Clinical Study ◽  
Conservative Treatment ◽  
Lateral Approach ◽  
Clinical Report ◽  
Sinus Lift ◽  
Sinus Floor Elevation ◽  
Long Term Follow Up ◽  
Sinus Floor

This clinical report describes a combined lateral-crestal approach to elevate the sinus floor when placing implants on a wide maxillary posterior ridge. The buccally enlarged osteotomy broadens vision of practitioners and facilitates access of instruments in the sinus. Compared to the traditional lateral approach of sinus lift, the proposed technique may offer a more conservative treatment modality. And a clinical study with sufficient subjects and long term follow up is needed to validate the potential and limitations of the proposed technique.

scholarly journals Follow-up study of compression fractures of the thoracic and lumbar vertebral bodies by conservative treatment.

1987 ◽  
Vol 35 (4) ◽  
pp. 1430-1434
Author(s):  
Takashi Toyoumi ◽  
Sekio Tominaga ◽  
Kazutomo Date ◽  
Keiji Ohuchi ◽  
Minoru Katayama ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Compression Fractures ◽  
Follow Up Study ◽  
Vertebral Bodies

scholarly journals Diastolic dyssynchrony in patients with LV only fusion pacing CRT without RV lead

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Gurgu ◽  
L Petrescu ◽  
C Vacarescu ◽  
CT Luca ◽  
C Mornos ◽  
...  
Keyword(s):  
Lateral Wall ◽  
Positive Outcome ◽  
Type I ◽  
Exercise Tests ◽  
Type Iii ◽  
Funding Sources ◽  
End Diastolic Volume ◽  
Chamber View ◽  
Systolic And Diastolic Function

Abstract Funding Acknowledgements Type of funding sources: None. Background CRT improves both systolic and diastolic function, thus increasing cardiac output. However, less data is available concerning diastolic dyssynchrony and fusion pacing CRT. The aim of our study was to assess the outcome of LV diastolic asynchrony in a population of fusion pacing CRT without right ventricular (RV)  lead. Methods Prospective data were collected from a cohort of patients (pts) with right atrium/left ventricle leads (RA/LV CRT). Baseline and every 6 months follow-up included standard ETT and classical dyssynchrony parameter measurements. Diastolic dyssynchrony was done by offline speckle-tracking derived TDI timing assesment of the simultaneity of E" and A"  basal septal and lateral wall 4 chamber view. New parameters were introduced: E" and respectively A" time (E"T / A"T) as the time difference between E" (respectively A" ) peaks septal and lateral wall. Exercise tests, drugs optimization and device individual programmimg were systematically performed in order to maintain constant fusion and improve CRT response. Patients were divided in three groups: super-responders (SR), responders (R) and non responders (NR). Results Sixty-two pts (35 male) aged 62 ± 11 y.o. with idiopathic DCM implanted with a RA/LV CRT were analyzed: 34%SR / 61%R / 5%NR. Baseline initial characteristics: QRS 164 ± 18 ms; EF 27 ± 5.2; 29% had type III diastolic dysfunction (DD), 63% type II DD, 8% type I DD. Average follow-up was 45 ± 19 months; mean LVEF at the last follow-up was 37 ± 7.9%. The E"T decreased from 90 ± 20 ms to 25 ± 10 ms in SR with significant LV reverse remodelling (LV end-diastolic volume 193.7 ± 81 vs 243.2 ± 82 ml at baseline, p &lt; 0.0028) and lower LV filling pressures (E/E" 13.2 ± 4.6 vs 11.4 ± 4.5, p =0.0295). DD profile improved in 65% of R with a reduction in E/A ratio (1.46 ± 5.3 vs. 0.82 ± 3.9 at baseline, p= 0.4453). Non-sudden cardiac death occurred in 3 NR pts (2%) with type III DD, severe LA volume and larger E" T /A"T (E"T&gt; 85 msec A"T &gt; 30 msec).  Significant cut off value calculated by ROC curve for LV diastolic dyssynchrony is E"T &gt; 80 ms and A"T of &gt; 25 msec. Conclusions Fusion pacing CRT without RV lead showed a positive outcome; improving LV diastolic dyssynchrony in responders and super-responders patients is obvious. Larger randomized studies are needed to define the role of diastolic asynchronism as a predictor of favorable response in fusion pacing. Abstract Figure. Typical TDI patterns in LV fusion pacing

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