Odontoid fracture
Last revised by Mohammad Taghi Niknejad on 26 Nov 2023
Citation, DOI, disclosures and article data
Citation:
Jones J, Niknejad M, Machang'a K, et al. Odontoid fracture. Reference article, Radiopaedia.org (Accessed on 08 Dec 2023) https://doi.org/10.53347/rID-6370
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rID:
6370
Article created:
16 Jun 2009, Jeremy Jones ◉
Disclosures:
At the time the article was created Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosuresLast revised:
26 Nov 2023, Mohammad Taghi Niknejad ◉
Disclosures:
At the time the article was last revised Mohammad Taghi Niknejad had no financial relationships to ineligible companies to disclose.
View Mohammad Taghi Niknejad's current disclosuresRevisions:
35 times, by 19 contributors - see full revision history and disclosures
Systems:
Sections:
Synonyms:
- Odontoid process fracture
- Dens fracture
- Odontoid peg fracture
- Odontoid fractures
- Odontoid peg fractures
- Dens fractures
- Odontoid process fractures
Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2.
Pathology
The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5.
Classification
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
Quiz questions
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References
- 1. Sayama C, Fassett D, Apfelbaum R. The Utility of MRI in the Evaluation of Odontoid Fractures. J Spinal Disord Tech. 2008;21(7):524-6. doi:10.1097/BSD.0b013e31815adeb5 - Pubmed
- 2. Hsu W & Anderson P. Odontoid Fractures: Update on Management. J Am Acad Orthop Surg. 2010;18(7):383-94. doi:10.5435/00124635-201007000-00001 - Pubmed
- 3. Jea A, Tatsui C, Farhat H, Vanni S, Levi A. Vertically Unstable Type III Odontoid Fractures: Case Report. Neurosurgery. 2006;58(4):E797; discussion E797. doi:10.1227/01.NEU.0000208555.34661.CD - Pubmed
- 4. Barker L, Anderson J, Chesnut R, Nesbit G, Tjauw T, Hart R. Reliability and Reproducibility of Dens Fracture Classification with Use of Plain Radiography and Reformatted Computer-Aided Tomography. J Bone Joint Surg Am. 2006;88(1):106-12. doi:10.2106/JBJS.D.02834 - Pubmed
- 5. Pal D, Sell P, Grevitt M. Type II Odontoid Fractures in the Elderly: An Evidence-Based Narrative Review of Management. Eur Spine J. 2011;20(2):195-204. doi:10.1007/s00586-010-1507-6 - Pubmed
- 6. Roy-Camille R, Saillant G, Judet T, de Botton G, Michel G. [Factors of Severity in the Fractures of the Odontoid Process (Author's Transl)]. Rev Chir Orthop Reparatrice Appar Mot. 1980;66(3):183-6. - Pubmed
Incoming Links
Articles:
- Levine and Edwards classification
- Retro-odontoid pseudotumour
- Alar ligament calcification
- Atlanto-occipital dissociation injuries
- Persistent ossiculum terminale
- Musculoskeletal curriculum
- Roy-Camille classification of odontoid process fracture
- Axis (C2)
- Odontoid process fixation
- Odontoid process agenesis
- Final FRCR Part B rapid reporting
- Atlanto-axial subluxation
- Spinal fractures
- RANZCR key conditions assessment
- Cervical spine fractures
- Os odontoideum
- Cervical spine radiograph (checklist)
- Cervical spine (odontoid view)
- Atlantoaxial fixation
Cases:
- Odontoid process fracture
- Odontoid process osteomyelitis with pathological fracture
- Odontoid fracture and incudomalleolar disruption
- Fall from height
- Atraumatic odontoid fracture - rheumatoid arthritis
- Anderson and D'Alonzo type III complex odontoid fracture
- Chronic posterior atlantoaxial subluxation associated with os odontoideum
- Odontoid fracture type II and Jefferson fracture
- Atlas (type 3b subtype 1) and axis (Anderson and D'Alonzo type 3, Roy-Camille type 2) fractures
- Odontoid fracture (Anderson and D'Alonzo type 3, Roy-Camille type 1)
- Odontoid fracture (Anderson and D'Alonzo type 2, Roy-Camille type 3)
- Odontoid fracture (Anderson and D'Alonzo type 3, Roy-Camille type 2)
- Intraosseous pneumatocyst of the first rib.
- Roy-Camille classification of C2 odontoid fractures (diagrams)
- Anderson and D'Alonzo classification of C2 odontoid fractures (diagrams)
- Os odontoideum
- Odontoid fracture
- Odontoid fracture - type 2
- Cervical spine: open mouth annotated view
- Type III Odontoid fracture
Multiple choice questions:
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