5) When an atlas fracture is associated with an axis fracture, patients may undergo external immobilization to allow C1 to heal prior to surgical repair of C2.
7% of cervical spine fractures in a series of 340 axis fractures.
Patients suffering from complex atlantoaxial fracture complicated with C1/2 or C2/3 instability should receive early surgery rather than other types of axis fracture.
Triple anterior screw fixation of an acute combination atlas- axis fracture.
2 Compared with the isolated atlas or axis fractures, complex Atlas-axis fractures have higher incidence of neurological impairment and mortality,5-7 and require early surgical stabilization.
Dynamic radiographs one year after surgery show fusion of the axis fracture
and preservation of physiologic movement at Cl-2 and C2-3.
Pryputniewicz DM, Hadley MN 2010 Axis Fractures
Neurosurgery 66 A68-A82
In the largest case series examining combined fractures, 43% of axis fractures
and 16% of atlas fractures occur in unison.