Odontoid fractures, systemic disease and conservative care.

Patients admitted to the Prince Henry Hospital Spinal Unit between January 1982 and January 1983 with a diagnosis of fracture of the odontoid process of the axis were reviewed. There were nine patients representing 20% of all new cervical fractures. The mean age was 64.5 +/- 19.3 years. Alcoholism, brain damage following head injury, osteo-arthritis, cervical spondylosis, rheumatoid arthritis and osteoporosis may be complicating factors in the management of odontoid fractures. A fracture of the odontoid in an elderly patient with a history of minimal trauma suggests osteoporosis. Early mobilization in a custom-moulded orthosis with frequent radiological monitoring prevents the complications of prolonged bed rest.