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Forum Name: Bone trauma and fractures

Question: C2 Fracture not healing


 apollo - Tue Jun 08, 2010 2:04 am

Hi,

I fractured my C2 over 3 months ago, and it seems to have gotten worse over time. It's a stable fracture and I'm only in a rigid cervical collar as a result. At the hospital the doctor said it'd take 3 months to heal up. 3 months ago the x-ray looked worse than it did a month prior to that. My next appointment is in two weeks. The x-rays taken at the 2 month mark is this:

Image

And at the 3 month mark:

Image

What could this mean in regards to recovery? Am I doing something wrong?? I'm very nervous right now as I haven't been able to work in my field, and the vast majority of my hobbies seem to revolve around physical activity. Thanks so much for your help.
 Dr.M.Aroon kamath - Sat Jun 12, 2010 1:38 am

User avatar Hi,
Going by the plain films you have attached, it appears to be a 'traumatic spondylolisthesis' (the so-called "hangman's" fracture). Consider yourself very lucky indeed to have come out of it without neurological deficits!

I am certain that full workup must have resulted in sub-classification of this fracture (based on CT & MRI, these fractures are classified as Types 1 to Type 3).I do not know if your neck was stabilized in a Halo initially.

Based on the type of fracture, the management options are
- conservative(non-operative) or
- surgical (some form of internal fixation).

As far as healing is concerned, fracture stabilization occurs in approximately 6-12 weeks.Frature stabilisation refers to mainly healing of the ligaments and other soft tissues around the site of the fracture so that abnormal mobility becomes restricted.Full radiological bony union (as per plain X-Rays) may take an indefinite amount of time.So,you need not worry too much about the way your fracture looks on a plain film.

In conclusion, what really matter are
- whether the patient's symptoms regress,
- that no new neurologic deficits appear &
- serial imaging shows progressive healing(stabiization) and no tendency towards displacement of the fractured bones.Your orthopedic surgeon will be the best person to guide you regarding the on-going management.

For all types of traumatic spondylolisthesis type of fractures, malunion and nonunion are the known significant complications of nonoperative management.Luckily, these are rare.
Good luck!

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