Odontoid Fractures - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes fracture types of the odontoid process.
Most common fractures of the axis
Type I: Stable Avulsion Fracture of the alar ligament near the tip of the Odontoid. Treatment is soft collar, be aware of significant ligamentous injury.
Type II: Fracture at the base of the Odontoid Process. Most common and a troublesome fracture. Nonunion rate is 20-80% due to interruptions of the blood supply.
Type IIa: comminuted and unstable.
High nonunion rate in patients over 50 years of age and more than 5 mm of displacement.
Posterior displacement extension injury is rare (anterior displacement Is more common-flexion injury). Delay in treatment. Gap of more than 2 mm.
Treatment of type II fractures
•Halo jacket traction may be needed initially to reduce fracture.
•Keep halo for approximately 3 months
•30% nonunion rate in halo.
•Fusion C1-C2 (fusion decreases rotation by 50%). Odontoid screw is preferred in the young patient. Indications for fusion :
1-Nonunion
2-Displaced fracture in older patients
3- Failure of the halo
4-Type II a (comminuted/unstable).
Type III: Fracture through the body of C2. Rich blood supply so heals in the majority of the cases.
Treatment
•Cervical orthosis
•Halo if displaced
Diagnosis of odontoid fractures
•Lateral view
•Open mouth view
•CT scan is the best
Odontoid fractures in the elderly
•Simple fall, usually a missed diagnosis
•Usually associated with increased complications and mortality
•Do not use a halo, use external orthosis
•Fibrous union might be adequate if the fracture is not badly displaced, otherwise do fusion of C1-C2.
Odontoid fractures in pediatrics
Synchondrosis between odontoid and the C2 body, fusion by the age of six. Odontoid fractures occur in young children around 4 years of age.
Treatment
•Minerva brace
•Halo vest if displaced: use more pins and less torque. Finger tightness.
Differential diagnosis- Os Odontoidium: with oval shaped sclerotic edges and the os is smaller than the normal dens. In type II dens fracture: the odontoid shape is preserved with sharp edges. Os is smaller than normal odontoid and fixed to the C1 anterior ring. Os Odontoidium looks like a fracture, but it is probably an old trauma.
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Пікірлер: 23

  • @nabilebraheim
    @nabilebraheim12 жыл бұрын

    THANKS FOR SHARING

  • @skibitom
    @skibitom10 жыл бұрын

    Many thanks doctor Nabil. Great educational video.Thanks for sharing.

  • @nabilebraheim
    @nabilebraheim12 жыл бұрын

    thanks

  • @nabilebraheim
    @nabilebraheim12 жыл бұрын

    thanks i have several ones that are very good

  • @dramadomido
    @dramadomido12 жыл бұрын

    many thanks doctor Nabil

  • @jiayongliu8420
    @jiayongliu842012 жыл бұрын

    Very nice video! Thanks for your great work!

  • @MrUmar62750
    @MrUmar627504 жыл бұрын

    Thank You For Amazing Video

  • @wintifan
    @wintifan12 жыл бұрын

    Nice video. I had a fracture of C2 Type II. After two sets of body casts it was recommended to fuse the odontoid to its base using 2 screws. The screws are still in there. It's been 20 years now since my car wreck, but i lead a mostly pain free life. I do have neck pain/muscle pain frequently but I live with it. I think it is better to live with pain than to not live at all.

  • @Isaac5123

    @Isaac5123

    Жыл бұрын

    Depending on the degree of pain

  • @dralgates1
    @dralgates112 жыл бұрын

    great work

  • @seeyinw
    @seeyinw11 жыл бұрын

    Great . Thanks !

  • @katiefinnegan4649
    @katiefinnegan46496 жыл бұрын

    Thanks for making this. Helping me understand my mums condition, she is 69 years old.

  • @MsIndiandoctor
    @MsIndiandoctor11 жыл бұрын

    very nice video... thanks

  • @unburrito
    @unburrito12 жыл бұрын

    Fabulous. Thanks a lot! =)

  • @skibitom
    @skibitom10 жыл бұрын

    This video is helpful but i need information about physio part thank you

  • @AmirahAltamimi
    @AmirahAltamimi5 жыл бұрын

    think youuuuuuu

  • @Wolfwolveswolf
    @Wolfwolveswolf7 жыл бұрын

    If you're 18, take your chances without the fusion! As my existence has been a Hell of constant Severe Chronic Pain due to a C1-C2 fusion, and I fought for two decades after it and in/with life ruining Pain- just to finally get a proper dosage of Morphine Medicine, that I used for 26 years and with NOT one dam problem from the Morphine Medicine (half of 26 years with a correct dosage, both dosages were high, but just a 80mg dosage increase made all the difference, and above a half of a gram was needed, but instead of learning from people like myself, nope they take the one thing that saved my life and flush it down the toilet, to save drug addicts. Well what about our lives, us people with Severe Chronic Pain?)- and thanks to Morphine that saved my life, I finally had somewhat of a life, my life still sucked pretty much, but I was able to deal with it having my Pain finally eased somewhat with Morphine Medicine, but now this United States has taken my Morphine Medicine away for nothing I have done wrong and won't let me use it again- just like they once did leaving me to suffer daily constant Pain for more than 10 years, the first more than 10 years, and all for nothing, but lies! As the one thing that did work- Morphine Medicine, they wouldn't let me use it, and why they told me I couldn't use it, was nothing, but big LIES! I would learn it was all lies and nothing more than that, as I used it for 26 years and it never stopped helping ease my Pain. So I was made to suffer in Pain every single day in constant Pain that did NOT stop and for more than 10 years, just to finally start to be treated for my Pain with Morphine Medicine. Made to suffer then and now again, for NOT one dam thing that I have done wrong! They just leave me to suffer again like some communist nation. They take all of what I had! After all I tried and went through while suffering in daily constant Pain for more than 10 years just to start being treated for my Pain with the one and only thing that ever did anything for my Pain. As if all I did and went through never happened. As that is how they now treat it all. As if the Doctors, the Pain Doctor who saved my life and the other two Doctors who played a part in saving my life, as if none of them existed too. As if they didn't know what they were doing. Total LUNACY is what it is!!! And evil too! I wish I'd of known then, what I know now, as I'd of taken my chances that the odontoid bone would have healed- hoping I still had time and that my body would still grow to the age of 21, or NOT, but either way I wouldn't have been suffering like I have had to for more than 37 years and the U.S. Government now makes me suffer again and Pain NOT eased- when I know the answer to my Pain is right there- the Morphine Medicine and correct dosage that works well, but they don't let me use the Morphine Medicine again and even though I have more than proven that it works (26 years with NOT one problem from the Morphine Medicine and I am like a normal person with the correct dosage that I need to use for my Pain (I mean normal as in NOT all drugged up like TV likes portray and lead the public to think, as the high/buzz bit from Morphine goes away quick, but the Morphine Medicine still works to lessen/ease Pain- so what's the problem people, oh that's right, you'd rather see other people and me suffer daily in constant Pain that not only ruins your life/existence, it destroys you, and they keep the truth about Morphine Medicine and how it works well for Severe Chronic Pain sickness hidden, yes to hide the truth and us Severe Chronic Pain sickness people are made to suffer in a torturous daily constant Pain! Which there has to be a sinister reason for why this is done to us, and the Truth about Morphine Medicine and how works for Severe Chronic Pain sickness is covered up and the Truth about it is hidden well, never acknowledged!!! I'm NO fool, I see what is being done!), but now they make me have to suffer again like when they made me suffer every single day with constant Pain for more than ten years and nothing else did a dam thing to ease my Pain (it's been more than 6 months now and they don't care! The first more than 10 years of having to suffer with nothing to ease my Pain, and after the 10 years of suffering I was finally starting to lose my mind from Pain, had NO control over it, and I could see it was the end of my life- Pain Doctor then saved my life with Morphine- opened the door and I eventually got the correct dosage more years down the road- 3 Doctors played a part in saving my life, but just as evil people do and like they are doing- the U.S. Government takes my Medicine away now again. It is more than hard for me to trust people, that didn't care when I suffered for more than 10 years daily in constant Pain, and even wonder if I was a fool for having gotten through it? And yeah us Severe Chronic Pain sickness people are Blacklisted in the United States (U.S. Government & Medical world)! Heck- they care more about Terrorists and their NOT being made to suffer, than they do for us people with Severe Chronic Pain and that we Severe Chronic Pain people have also done nothing wrong! My fusion is not exactly in place right, but too dangerous to do anything to. I also had a severe head injury and was not conscious for a month and far from up to par when first trying to figure out who I was and what was going on. Had severe injuries and broken bones to my face, head, and upper body that have not helped the matter at all also. And this was all due to the fault of an illegally drunken driver in an 18 wheeler truck who caused a head on collision (killed my two friends 19 & 20 years old, and we did nothing wrong, had the facts of collision and State Police backing our innocence)! They cared about the trucking company, and we were the expendable young Males. Got peanuts for this Hell of suffering, and a ruined life. So my words of advice, screw the fusion and take your chances, as this world is a Hell anyways! I didn't have the mind also to make the decision properly- and when my odontoid was found broken clean through seven weeks after and had not moved out of place- kind of hard to think if it was luck or actually a curse, but if I could have, I'd of skipped the fusion and hoped it would heal, or not and I'd been gone, respiratory shut down and not suffering. For if I'd known then what I would go through for 37 years and counting, and how I would be treated by the U.S. Government and made to suffer for so long and based on nothing, BUT LIES, and as if I was some kind of criminal, because I suffered from daily constant Pain and nothing worked to ease the Pain- but for Morphine Medicine which is a G-d Send, Miracle Medicine, a Life Saver- (if they let you even use it). And people will have no idea or understand what you will go through for Pain and suffering due to your Severe Chronic Pain. Trust me, no matter how much you try to explain your Pain and suffering, and even when you are throwing up from Pain, they will blame it on suspicion of Narcotics, even though you are NOT even using it! Ha, yeah go figure that screwed up one, but that's the kind of stuff you will deal with if your fusion is NOT right like mine is. But they prefer to call the one and only thing that saved my life from Pain and gave me somewhat of a life, yeah they prefer to call it bad! Bad this, bad that, bad- bad- bad- and I'm tired of hearing their Bull Shit LIES! Of course the few Doctors who know the truth about how well Morphine Medicine works for Severe Chronic Pain and that it is the only thing worth even talking about in relation to easing Severe Chronic Pain, but the few very rare Doctors are warned by the DEA to stop using Morphine Medicine, to stop helping us people who are suffering every day with constant Pain, yes to stop helping us, or that they will lose their Medical License and all they worked for in Medicine! And if they dare push it, their own family members will be at risk for NO longer walking on the earth. We are dealing with a great monster, and this is the world of LIES. Which it all runs very deep, far, sinister, and through everything you could even imagine and then some! I need to warn people about the Truth, and who knows how much worse all of this may soon be! I now awake each day again- to a Nightmare- the Pain and suffering. Think real hard about the fusion, I don't recommend it! As this is NOT at all a life! Though perhaps all of this is done, to see how far they can push us, till we lose our mind, commit suicide, some who will strike out in some way possibly, and due to what the Hell of Pain and suffering does to our mind, etc., etc.. But I do wonder if this is the sinister reason for doing this to us.

  • @31spa

    @31spa

    6 жыл бұрын

    Wolfwolveswolf. My daugther is only 8years old and broke her C1 8 months ago. Wore the halo for 3 months and now after 5 months they said that her bone didn't heal and needs this fusion, I really don't want her have it since she is not on pain at all. Do you think she can be ok with out this surgery? Thanks

  • @nabilebraheim
    @nabilebraheim12 жыл бұрын

    thanks

  • @mikefonf6531
    @mikefonf653111 жыл бұрын

    this video is helpful but i need information about physio part thank you

  • @ElizabethKelly5200

    @ElizabethKelly5200

    5 жыл бұрын

    I had an odontoid fracture type 1 (tip of the odontoid accounting for 5 to 15% of C2 type fractures) I was in a hard aspen collar for 3 months. I slept on my back in an at-home reclining positioned hospital bed. After 3 mos. when the collar was removed I was successfully able to raise my head up, down left, right side position. My good recovery was due to faithfully wearing the aspen collar 24/7 and faithfully maintaining the sleep position listed above. Mentally and emotionally it was very difficult. I am 79 years old and thank God it wasn't a type 2 or 3 fracture where the odontoid was split in the middle or the base. I might not have recovered from that.

  • @nabilebraheim
    @nabilebraheim12 жыл бұрын

    thanks

  • @31spa

    @31spa

    6 жыл бұрын

    nabil ebraheim Hi can I ask you more questions about this ?