Are hard collars necessary for older people with odontoid neck fractures?

What you need to knowPatient age, frailty, comorbidities, and injury severity are important predictors of outcome after an odontoid fractureSurgical fixation improves bony healing, but not patient outcomesHard collars can impair swallowing and mobility, and cause pressure soresNeck (cervical) fractures can occur when older or frail people sustain a low impact fall. These fractures are increasing in incidence as the population ages. The second cervical vertebra, known as the odontoid peg, or dens, is most affected1 (fig 1). More than 85% of odontoid fractures occur in people over 65.2 In standard care in the UK and elsewhere, most patients with suspected cervical spine injuries are immobilised with non-padded trauma collars or blocks, possibly on spinal boards, on admission to the emergency department. A hard collar is usually applied once a cervical fracture is diagnosed.bmj;381/jun02_1/e072956/F1F1f1Fig 1Sagittal computed tomogram (CT) showing a minimally displaced fracture of the second vertebrae and odontoid pegSurgical…
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