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Joseph Junewick, MD FACR
over 7 years ago
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Odontoid Fracture - High

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

17 year old involved in a motor vehicle accident.


Case Images


Diagnosis

Odontoid Fracture – Type 1

Findings

CT – Nondisplaced oblique fracture of the odontoid; the fracture does not extend to the synchondrosis scar.

Discussion

Anderson and D’Alonzo classify odontoid fractures as Type I (alar ligament avulsion), Type II (fracture at the base of the odontoid) and Type III (fracture of the anterior superior body of the axis). There is controversy over the existence of the type I. Others suggest designating odontoid fractures as “high” or “low”. High fractures are limited to the lower odontoid, usually not above the level of the accessory ligaments unless the fracture is comminuted. High fractures rarely occur in infants and children. Since the odontoid is largely composed of cortical bone, nonunion is a common complication especially if the fragment is displaced. Low fractures are mechanically unstable. Odontoid fractures are associated with fractures of the face, atlantooccipital dissociation, extension teardrop injuries, and Jefferson fractures.

Reference

Harris JH and Mirvis SE. The Radiology of Acute Cervical Spine Trauma, 3rd Ed. Williams and Wilkins (1996).



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