Management of Massively Displaced Type II Odontoid Fracture in an Obese Patient in a Resource-Challenged Facility: A Case Report of an Anterior Screw Osteosynthesis Technique.

Abstract

The surgical management of a 22-year-old obese patient with a massively displaced type II odontoid fracture through anterior osteosynthesis (using a cannulated titanium screw of size 4.0 mm by 35 mm) in a resource-challenged facility is reported. The fracture was transverse at the waist of the dens with huge anterior-lateral displacement and overlapping. This fracture was unique in term of its displacement and overlapping nature of the fragment from routinely seen cases. The management was also challenged with the patient's obesity, lack of a Mayfield device, and a nonadjustable operating table. The patient underwent the surgery and gradually and satisfactorily improved with full pre-injury functional status.