The non-operative treatment of unstable traumatic Anderson's type II odontoid fractures has a high risk potential to develop non-unions. Even after operative stabilization literature reveals non-union rates up to 20%. Acute life threatening complications are
tetraplegia and apnoea. Long-term complications induce chronic
myelopathy resulting from persistent myeloradicular compression. We report the case of a patient with a 17-year-old post-traumatic
pseudarthrosis of the dens axis following
conservative treatment of an unstable type II fracture. By that time, the female patient, then 37 years old, was admitted to our hospital with early signs of cervical
tetraplegia. After initial reposition and short-term immobilization with a halothoracic vest we performed a ventrodorsal atlantoaxial
spondylodesis. Failure of anterior cervical plate stabilization and autologous graft resorption without a solid segmental fusion instigated a secondary surgical intervention. Postoperative
therapy-resistant oral
wound dehiscence showed an exposed autograft and osteosynthetic material. The reported positive effect of
hyperbaric oxygenation on wound healing in problem cases led us to attempt this means of
therapy. With a daily exposure to
hyperbaric oxygenation, the dehiscence closed within 25 days. As a result of our experience in this case,
hyperbaric oxygenation should be considered as a therapeutic option in postoperative complication management in orthopaedic surgery.