(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.
C2 fractures represented 18.7% of cervical spine fractures in a series of 340 axis fractures. (10) Automobile collisions are the most frequent mechanism of injury, followed by falls.
Axis fractures: A comprehensive review of management and treatment in 107 cases.
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. Moreover, surgical treatment must be performed for patients with C1 fracture complicated with type II odontoid fracture and atlas transverse ligament rupture.21 If C1 posterior arch is absent or unstable, posterior C1-C2 pedicle screws, transarticular screw or occipital-cervical fusion could be used during surgery.21
Triple anterior screw fixation of an acute combination atlas- axis fracture. Case report.
Incidence and Cost of Treating Axis Fractures
in the United States From 2000 to 2010.
Sonntag, "Acute axis fractures. Analysis of management and outcome in 340 consecutive cases," The Spine Journal, vol.
Sonntag, "Acute axis fractures: A review of 229 cases," Journal of Neurosurgery, vol.
Sonntag, "Acute axis fractures
: analysis of management and outcome in 340 consecutive cases," Spine, vol.
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.