Odontoid fractures if left untreated can result in long term instability and atlanto-axial dislocation. Fixation can be done using ventral (trans-odontoid screw) or dorsal approach. The benefit of trans-odontoid screw fixation is that it allows for complete range of movement at the atlanto-axial joint.
This patient presented with neck pain following a fall. Imaging showed fracture of Odontoid through the base of the odontoid without any dislocation with intact posterior longitudinal ligament.
Trans-odontoid screw was inserted under C-arm guidance. Post-op scan shows reduction of the fracture. Post-op recovery was uneventful with no deficit.