Posterior C1-C2 Fixation Using Absorbable Suture for Type II Odontoid Fracture in 2-Year-Old Child: Description of a New Technique and Literature Review.

Abstract

Odontoid synchondrosis fractures are rare in children, even though they are the more common cervical fracture in children less than 7 years old. Nonoperative treatment with external orthosis immobilization is the treatment of choice for stable undisplaced or minimally displaced injuries. In unstable fractures, when reduction cannot be achieved or maintained, surgical fixation is recommended. We report a 2-year-old boy with an unstable fracture of the odontoid treated surgically using an absorbable monofilament suture for C1-C2 interlaminar fixation without bone grafting. This suture was strong enough to provide the stability necessary to allow healing of the synchondrosis and the delayed resorption of the suture was followed by complete restoration of the mobility between C1 and C2. This case illustrates that surgical stabilization using an absorbable suture in young children with an unstable odontoid fracture is a safe and effective alternative to other surgical techniques. Level III.