Odontoid fracture
Citation, DOI, disclosures and article data
Citation:
Jones J, Knipe H, Silverstone L, et al. Odontoid fracture. Reference article, Radiopaedia.org (Accessed on 19 Jan 2025) https://doi.org/10.53347/rID-6370
rID:
6370
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Disclosures:
At the time the article was created Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Micro-X Ltd, Shareholder (past)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Henry Knipe's current disclosures
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21 contributors -
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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
-
most commonly used, describes level of fracture line (i.e. through tip, base, or lateral masses)
Type I: Avulsion fracture of the upper dens; usually stable
Type II: Transverse fracture of the base of dens; unstable
Type III: Fracture at the body of C2
-
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
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- Musculoskeletal curriculum
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- Axis (C2)
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- Os odontoideum
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Cases:
- C2 fracture
- Odontoid fracture (paediatric)
- Odontoid fracture
- Craniocervical junction stenosis with spinal cord myelomalacia
- Type II dens fracture
- Type 1 C2 odontoid fracture
- 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)
Multiple choice questions:
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