Make up ~7% of cervical spine fractures risk of neurologic injury is low.
Commonly missed due to inadequate imaging of occipitocervical junction.
Type I Isolated anterior or posterior arch fracture. A plough fracture is an isolated anterior arch fracture caused by a force driving the odontoid through the anterior arch.
Type II see Jefferson fracture
Type III Unilateral lateral mass fracture. Stability determined by integrity of transverse ligament.
includes hyperextension, lateral compression, and axial compression
C2 spine fracture
50% have an associated spine injury
40% associated with axis fracture
Surgical management may be difficult and challenging due to the anatomical relationship sbetween the vertebrae and neurovascular structures.
stability dependent on degree of injury and healing potential of transverse ligament