In younger patients, odontoid fractures usually result from high-energy trauma, such as motor vehicle or diving accidents. In the elderly, the fracture can occur from lower energy impacts, such as falling from own height. 

Fractures of C2 are the most common cervical spine injuries in the elderly, and most frequently are of the odontoid process.

Anderson and D'Alonzo classification is widely used for classifying odontoid fractures, based on their location, extension and stability. Type III fractures extend from the base of the odontoid into the vertebral body and may involve variable portion of the lateral facets. Type III odontoid fractures are relatively stable with low risk of non-union, if not excessively displaced.

Case co-author: Rehana Jaffer, MD, FRCPC

Case courtesy of Dr. Mathieu Boily