Odontoid fracture

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Odontoid fracture
Usual onsetYoung adults, very elderly[1]
TypesI, II, III[2]
Risk factorsMotor vehicle accidents, falls[1]
Diagnostic methodX-ray (open mouth view)[1]
Differential diagnosisHangman's fracture[1]
Frequency10% to 15% of all cervical spine fractures[1]

Odontoid fracture is a break of the odontoid process, the top bony projection of the second cervical vertebrae at the top of neck.[2] It may be a simple chip of the tip as in type 1, break of the base of the odontoid as in type II, or type III if the break extends into the body of C2.[3]

It usually results from trauma when the neck is hyperextended, pushing the head and first cervical vertebrae backwards, typically in a motor vehicle accident or fall.[1] It can also occur if the neck is excessively bent forwards.[1] Diagnosis is by X-ray.[1] Taking the X-ray through an open mouth allows the odontoid peg to be assessed and to see its relationship with the sides of the first cervical vertebrae.[4]

It is the most common type of C2 fracture and accounts for 10% to 15% of all cervical spine fractures.[1] They occur most frequently in young adults, due to motor vehicle accidents and very elderly, due to falls.[1]



  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 Tenny, Steven; Varacallo, Matthew (2022). "Odontoid Fractures". StatPearls. StatPearls Publishing. Archived from the original on 2022-06-17. Retrieved 2022-09-18.
  2. 2.0 2.1 Stahel, Philip F.; Weckbach, Sebastian (2022). "20. Spine fractures". In Pape, Hans-Christoph; Jr, Joseph Borrelli; Moore, Ernest E.; Pfeifer, Roman; Stahel, Philip F. (eds.). Textbook of Polytrauma Management: A Multidisciplinary Approach (3rd ed.). Springer. pp. 244–245. ISBN 978-3-030-95906-7. Archived from the original on 2022-09-27. Retrieved 2022-09-18.
  3. Ross, Jeffrey S. (2020). "Section 2. Trauma, Vertebral columns, disco and paraspinal muscles. Odontoid C2 fracture". In Ross, Jeffrey S.; Moore, Kevin R. (eds.). Diagnostic Imaging: Spine. Elsevier Health Sciences. ISBN 978-0-323-79400-8. Archived from the original on 2022-09-27. Retrieved 2022-09-24.
  4. White, Timothy O.; Mackenzie, Samuel P.; Gray, Alasdair J. (2016). "14. Spine". McRae's Orthopaedic Trauma and Emergency Fracture Management (3rd ed.). Elsevier. pp. 300–302. ISBN 978-0-7020-5728-1. Archived from the original on 2021-08-28. Retrieved 2022-09-21.