{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T09:56:31Z","timestamp":1753437391896},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In a consensus process with four sessions in 2017, the working group \u201cupper cervical spine\u201d of the German Society for Orthopaedics and Trauma Surgery (DGOU) formulated \u201cTherapeutic Recommendations for the Diagnosis and Treatment of Upper Cervical Fractures\u201d, taking their own experience and the current literature into consideration. The following article describes the recommendations for axis ring fractures (traumatic spondylolysis C2). About 19 to 49% of all cervical spine injuries include the axis vertebra. Traumatic spondylolysis of C2 may include potential discoligamentous instability C2\/3. The primary aim of the diagnostic process is to detect the injury and to determine potential disco-ligamentous instability C2\/3. For classification purposes, the Josten classification or the modified Effendi classification may be used. The Canadian C-spine rule is recommended for clinical screening for C-spine injuries. CT is the preferred imaging modality and an MRI is needed to determine the integrity of the discoligamentous complex C2\/3. Conservative treatment is appropriate in case of stable fractures with intact C2\/3 motion segment (Josten type 2 and 2). Patients should be closely monitored, in order to detect secondary dislocation as early as possible. Surgical treatment is recommended in cases of primary severe fracture dislocation or discoligamentous instability C2\/3 (Josten 3 and 4) and\/or secondary fracture dislocation. Anterior cervical decompression and fusion (ACDF) C2\/3 is the treatment of choice. However, in case of facet joint luxation C2\/3 with looked facet (Josten 4), a primary posterior approach may be necessary.<\/jats:p>","DOI":"10.1055\/a-0620-9170","type":"journal-article","created":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T23:40:06Z","timestamp":1529710806000},"page":"662-671","source":"Crossref","is-referenced-by-count":11,"title":["Recommendations for Diagnosis and Treatment of Fractures of the Ring of Axis"],"prefix":"10.1055","volume":"156","author":[{"given":"Matti","family":"Scholz","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Wirbels\u00e4ulenchirurgie und Neurotraumatologie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Schleicher","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Wirbels\u00e4ulenchirurgie und Neurotraumatologie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Kandziora","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Wirbels\u00e4ulenchirurgie und Neurotraumatologie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Badke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall- und Wiederherstellungschirurgie, BG Unfallklinik T\u00fcbingen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Dreimann","sequence":"additional","affiliation":[{"name":"Wirbels\u00e4ulenchirurgie, Universit\u00e4tsklinikum Hamburg-Eppendorf"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Gebhard","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Orthop\u00e4die und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, Liestal, Schweiz"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erol","family":"Gercek","sequence":"additional","affiliation":[{"name":"Orthop\u00e4die und Unfallchirurgie, Gemeinschaftsklinikum Mittelrhein, Koblenz"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Gonschorek","sequence":"additional","affiliation":[{"name":"Wirbels\u00e4ulenchirurgie, BG-Unfallklinik Murnau"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9","family":"Hartensuer","sequence":"additional","affiliation":[{"name":"Unfall-, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsklinikum M\u00fcnster"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan-Sven","family":"Jarvers","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Orthop\u00e4die, Unfallchirurgie und Plastische Chirurgie, Universit\u00e4tsklinikum 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