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

What is the necessary intervention for a C-2 odontoid type 2 fracture?

1. Fusion or halo

2. Immediate cervical traction

3. Observation

4. Physical therapy

The correct answer is: Fusion or halo

A C-2 odontoid type 2 fracture typically requires surgical intervention, particularly fusion or the application of a halo device. The rationale for this approach is based on the nature of the fracture, which involves a break at the base of the odontoid process, often compromising stability in the cervical spine. The risk of nonunion is significant with these fractures, especially in older adults, and nonunion can lead to increased morbidity or mortality associated with instability or injury to the spinal cord. Fusion is preferred in cases where there is evidence of instability or risk of nonhealing, while a halo can provide necessary immobilization and support during the healing process. These methods aim to promote proper alignment and maintain stability during the recuperation period, thereby reducing the chance of neurological complications. In contrast, immediate cervical traction, observation, and physical therapy do not address the need for stabilization and could leave the patient vulnerable to further injury or issues related to instability. Therefore, the appropriate intervention for a C-2 odontoid type 2 fracture is to either perform a fusion or utilize a halo for immobilization.