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Dr nitin garg

Odontoid fracture

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.

Pre-op T2W sagittal MRI with odontoid type II fracture

Pre-op CT scan with fracture through the base of odontoid

Pre-op CT scan with fracture through the base of odontoid

Post-op CT scan (sagittal image) with trans-odontoid screw in-situ

Post-op CT scan shows reduced bone fragement following fixation
Dr Nitin Garg