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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