Odontoid fracture

There are three types:

■ type 1 - the tip of the odontoid is involved (rare usually stable);

■ type 2 - odontoid fracture is a fracture of the base of the odontoid 200 (unstable ^ 6 mm displacement) (Figs 4.40 and 4.41);

Fig. 4.42 Dens fracture. Lateral cervical spine. A break in the inferior margin of the sclerotic ring found in the body of C2 (Harris' ring), along with prevertebral soft tissue swelling (arrow). This indicates a type 3 dens fracture. This can be the only view where this type of fracture is identified - on the AP odontoid view (Fig. 4.44) the fracture is not visible.

Fig. 4.42 Dens fracture. Lateral cervical spine. A break in the inferior margin of the sclerotic ring found in the body of C2 (Harris' ring), along with prevertebral soft tissue swelling (arrow). This indicates a type 3 dens fracture. This can be the only view where this type of fracture is identified - on the AP odontoid view (Fig. 4.44) the fracture is not visible.

Fig. 4.43 Odontoid fracture (dens fracture). Lateral cervical spine (close up of Fig. 4.42). Disruption of this ring (arrow) may be the only sign of a dens fracture. Soft tissue thickening at C1 level is also present (dotted arrows).

■ type 3 is a fracture through the base of the odontoid that extends through the body of the C2 vertebra.

This is usually a stable injury with a good prognosis, and is identified on the lateral by disruption of Harris' ring [6] (Figs 4.42-4.44). 201

Fig. 4.44 Odontoid (dens fracture). AP peg view. Same patient as Fig. 4.42. A fracture through the body of C2 is not appreciated on the odontoid peg view.

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