Odontoid fracture in teenage girl

Case contributed by Gerry Gardner

Presentation

Pedestrian hit by a car travelling at 40 mph. She presented with facial injuries and a painful neck and pelvis.

Patient Data

Age: 13 years
Gender: Female
X-ray

Lateral view showing C1 anterior soft tissue swelling and C2 fracture.

Inadequate odontoid view.

Single sagittal and a single axial view demonstrating the odontoid process fracture.

Comminuted displaced fracture through the base of the odontoid process (i.e. type II) .

Case Discussion

Initial survey cleared the chest and pelvis. ED staff were unhappy to clear the neck and referred her to orthopedics who cleared the spine and requested facial views which were done.

In the morning a CT facial bones was requested. At this point the cervical films were reviewed and an odontoid fracture was identified. 

CT confirmed the presence of a comminuted displaced type II odontoid fracture.

The patient was transferred to a neurosurgical center. Conservative treatment in a halo was initiated.

The patient is doing well with no adverse effects.

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Case information

rID: 13913
Published: 30th May 2011
Last edited: 13th Aug 2019
Inclusion in quiz mode: Included

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