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Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra

Many anterior C2 (2nd cervical vertebra) tear drop (TD) fractures can be successfully managed with conservative treatment. However, due to the occurrence of nonunion, large-sized or complex anterior C2 TD fractures undergo surgical treatment. To date, no surgical treatment guidelines are available a...

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Autores principales: Kim, Sung-Kyu, Rhee, John M., Park, Eric T., Seo, Hyoung-Yeon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126078/
https://www.ncbi.nlm.nih.gov/pubmed/34068661
http://dx.doi.org/10.3390/jcm10092037
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author Kim, Sung-Kyu
Rhee, John M.
Park, Eric T.
Seo, Hyoung-Yeon
author_facet Kim, Sung-Kyu
Rhee, John M.
Park, Eric T.
Seo, Hyoung-Yeon
author_sort Kim, Sung-Kyu
collection PubMed
description Many anterior C2 (2nd cervical vertebra) tear drop (TD) fractures can be successfully managed with conservative treatment. However, due to the occurrence of nonunion, large-sized or complex anterior C2 TD fractures undergo surgical treatment. To date, no surgical treatment guidelines are available about anterior C2 TD fractures. Therefore, we performed this study to investigate the factors that may affect nonunion for anterior C2 TD fractures and to suggest surgical treatment guidelines. Thirty-three patients with anterior C2 TD fractures, who underwent conservative treatment and had a minimum 1-year follow-up, were divided into union (N = 26) and nonunion (N = 7) groups. Their radiological and clinical data were analyzed retrospectively and compared between the two groups. The avulsion fracture ratio (29.5% vs. 43.3%, p < 0.05) and fracture displacement (3.6 mm vs. 5.1 mm, p < 0.05) were higher in the nonunion group compared to the union group. Incidence of associated C2 injury was higher in the nonunion group compared to the union group (15.4% vs. 57.1%, p < 0.05). Union status was negatively correlated with associated C2 injury (correlation coefficient, CC = −0.398, p < 0.05). Our results suggest that surgical treatment could be considered for anterior C2 TD fractures with an avulsion fracture ratio > 43%, fracture displacement > 5 mm, or associated C2 injury.
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spelling pubmed-81260782021-05-17 Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra Kim, Sung-Kyu Rhee, John M. Park, Eric T. Seo, Hyoung-Yeon J Clin Med Article Many anterior C2 (2nd cervical vertebra) tear drop (TD) fractures can be successfully managed with conservative treatment. However, due to the occurrence of nonunion, large-sized or complex anterior C2 TD fractures undergo surgical treatment. To date, no surgical treatment guidelines are available about anterior C2 TD fractures. Therefore, we performed this study to investigate the factors that may affect nonunion for anterior C2 TD fractures and to suggest surgical treatment guidelines. Thirty-three patients with anterior C2 TD fractures, who underwent conservative treatment and had a minimum 1-year follow-up, were divided into union (N = 26) and nonunion (N = 7) groups. Their radiological and clinical data were analyzed retrospectively and compared between the two groups. The avulsion fracture ratio (29.5% vs. 43.3%, p < 0.05) and fracture displacement (3.6 mm vs. 5.1 mm, p < 0.05) were higher in the nonunion group compared to the union group. Incidence of associated C2 injury was higher in the nonunion group compared to the union group (15.4% vs. 57.1%, p < 0.05). Union status was negatively correlated with associated C2 injury (correlation coefficient, CC = −0.398, p < 0.05). Our results suggest that surgical treatment could be considered for anterior C2 TD fractures with an avulsion fracture ratio > 43%, fracture displacement > 5 mm, or associated C2 injury. MDPI 2021-05-10 /pmc/articles/PMC8126078/ /pubmed/34068661 http://dx.doi.org/10.3390/jcm10092037 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Sung-Kyu
Rhee, John M.
Park, Eric T.
Seo, Hyoung-Yeon
Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra
title Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra
title_full Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra
title_fullStr Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra
title_full_unstemmed Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra
title_short Analysis of Nonunion in Conservatively Managed Anterior Tear Drop Fractures of C2 Vertebra
title_sort analysis of nonunion in conservatively managed anterior tear drop fractures of c2 vertebra
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126078/
https://www.ncbi.nlm.nih.gov/pubmed/34068661
http://dx.doi.org/10.3390/jcm10092037
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