American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the treatment approach for a C-2 odontoid type 3 fracture?

1. Fusion or halo

2. Reduction and stabilization

3. Immediate surgery

4. Observation only

The correct answer is: Fusion or halo

In the treatment of a C-2 odontoid type 3 fracture, the correct approach typically involves fusion or halo immobilization. A type 3 odontoid fracture involves a fracture at the base of the odontoid peg, and it has been shown that these fractures can lead to instability and nonunion if not managed appropriately. Surgical intervention, often in the form of fusion, is considered to provide stability to the cervical spine and promote healing, especially in cases where the fracture is displaced or if there are neurological concerns. The halo vest can also be used to immobilize the region and allow for healing to occur without surgical intervention in less complex or unstable scenarios. This is significant because effective stabilization helps prevent future complications, such as cervical spine instability or neurological deficits. Other treatment options like reduction and stabilization, immediate surgery, or observation alone might be considered in specific contexts, but the most widely recommended approach for type 3 fractures revolves around fusion or the use of a halo to ensure proper healing and alignment.