Current studies recommend nonsurgical management of Type III odontoid fractures with union rates of 85%–100% with external immobilization.Ī considerable amount of heterogeneity exists among Type III fractures. In general, the Type III fracture is believed to have high healing potential due to large fracture surface area through cancellous bone.
Type III fractures extend into the vertebral body and account of 39% of all odontoid fractures. Type II fractures occur at the junction of the dens and the C2 vertebral body. Type I fractures occur at the proximal tip of the dens from an avulsion injury. The Anderson and D'Alonzo classification is the most commonly utilized classification system. The great majority of odontoid fractures occur in the elderly population from a low-energy mechanism with a smaller contribution from high-energy accidents in the young. The incidence of odontoid fractures varies between age groups and is generally believed to account for approximately 20% of all cervical spine injuries.
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