Odontoid fracture

Dr Jeremy Jones et al.

Odontoid process fracture, also known as the peg or dens fracture, occurs where there is a fracture through the odontoid process of C2.


The mechanism of injury is variable, and can occur both during flexion or extension with or without compression 5.


There are two classification systems 5,6

  • Anderson and D'Alonzo
    • most commonly used
    • describes level of fracture line (i.e. through tip, base, or lateral masses)
  • Roy-Camille classification
    • has been shown to better correlate with prognosis
    • ​describes plane of fracture and displacement

Differential diagnosis

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