Clinical and Radiological Outcomes of Halo Vest Application for Type II and III Odontoid Fractures

Objective: To assess halo vest applications for type II and III odontoid fractures and to ascertain the radiological and clinical outcomes of this approach.

Methods: A cross-sectional retrospective study was conducted by reviewing the medical charts of selected patients having type II and III odontoid fractures who underwent halo vest treatment at the King Saud Medical City Orthopaedic Department. Radiographic evaluations for the cervical spine (anterior-posterior, lateral, and open-mouth views) were used. Computed tomography scans were used to delineate the extent of the fracture and to measure the magnitude of displacement, the degree of the angulation, the vertebrae involved, and the fracture type.

Results: A total of 45 patients with odontoid fractures (55.6% of the patients with type II odontoid fractures and 44.4% of patients with type III) received halo vest treatment. In the present study, in type II odontoid fractures, union was achieved in 15.6% of patients, 28.9% of patients had malunion and 11.1% had nonunion. In type III odontoid fractures, union cases comprised 15.6% of patients, while malunion cases accounted for 28.9% of patients and nonunion cases were found in 4.4% of the patients.

Conclusion: The halo vest management for type II and III odontoid fracture requires a prolonged course of cervical immobilisation. Multiple factors contribute to the alteration of the management protocol, patient adherence, and difficulties related to HV, and a significant rate of reduction loss ultimately results in malunion or nonunion.