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Innovative Neurosurgery

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SOMI brace immobilization as a treatment option for inveterate hangman’s fracture in pediatric patients

Alessandro Landi
  • Corresponding author
  • Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, Rome, Italy
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/ Pasquale Donnarumma
  • Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, Rome, Italy
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/ Alfredo Altomonte
  • Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, Rome, Italy
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/ Roberto Delfini
  • Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, Rome, Italy
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/ Giampaolo Cantore
Published Online: 2014-05-20 | DOI: https://doi.org/10.1515/ins-2013-0015

Abstract

Traumatic spondylolisthesis of C2 occurs when the mechanical event at the base of the trauma is a compression force on the vertex. Management of this is well defined in literature, and both surgical and conservative treatments have been proposed in adults. In contrast, the principles of treatment are somewhat more uncertain and less well defined in children. One of the most frequently suggested treatments is the early reduction of the fracture, with immobilization in halo. Other types of cervical orthoses are not recommended. This article reports on a rare case of an inveterate hangman’s fracture in a 12-year-old girl that is healing completely through immobilization in a SOMI brace that was applied 4 months after the trauma. In our experience, hangman’s fracture is poorly defined with regard to the treatment of pediatric patients, and there are currently no established guidelines. If dynamic X-ray scans show complete reduction of the fracture, conservative treatment is an efficient, effective, and noninvasive solution, even in case of inveterate fractures. Halo vest and SOMI brace are good solutions. SOMI brace is an available option because it is less traumatic for the patient.

Keywords: Child; conservative treatment; hangman’s fracture; pediatric patients; SOMI brace.

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About the article

Corresponding author: Alessandro Landi, Department of Neurology and Psychiatry, Division of Neurosurgery, University of Rome “Sapienza”, Viale del Policlinico 155, Rome 00181, Italy, E-mail:


Received: 2013-12-09

Accepted: 2014-04-22

Published Online: 2014-05-20

Published in Print: 2014-12-01


Citation Information: Innovative Neurosurgery, Volume 2, Issue 1-4, Pages 21–24, ISSN (Online) 2193-5238, ISSN (Print) 2193-522X, DOI: https://doi.org/10.1515/ins-2013-0015.

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