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Odontoid process fracture, also known as a 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, and 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)
- has been shown to better correlate with prognosis
- describes plane of fracture and displacement
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- 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