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 inchildren less than 7 years old. Nonoperative treatment withexternal orthosis immobilization is the treatment of choice forstable undisplaced or minimally displaced injuries. In unstablefractures, when reduction cannot be achieved or maintained,surgical fixation is recommended. We report a 2-year-old boywith an unstable fracture of the odontoid treated surgically us-ing an absorbable monofilament suture for C1-C2 interlaminarfixation without bone grafting. This suture was strong enough toprovide the stability necessary to allow healing of the syn-chondrosis and the delayed resorption of the suture was fol-lowed by complete restoration of the mobility between C1 andC2. This case illustrates that surgical stabilization using an ab-sorbable suture in young children with an unstable odontoidfracture is a safe and effective alternative to other surgicaltechniques.Level of Evidence: Level III.Key Words: children odontoid synchondrosis fracture, posteriorC1-C2 absorbable suture fixation, unstable odontoid fracture(J Pediatr Orthop 2015;00:000–000)