Odontoid fracture clinical features

The frequency of fatalities at the time of the accident resulting directly from odontoid fractures is unknown, it has been estimated as being between 25–40%. 82% of patients with Type II fractures in a review of 7 reports in the literature were neurologically intact, 8% had minor deficits of scalp or limb sensation, and 10% had significant deficits (ranging from monoparesis to quadriplegia).

Type III fractures are rarely associated with neurologic injury.

Common symptoms are high posterior cervical pain, sometimes radiating in the distribution of the greater occipital nerve (occipital neuralgia). Almost all patients with high posterior cervical pain will also have paraspinal muscle spasm, reduced range of motion of the neck, and tenderness to palpation over the upper cervical spine. A very suggestive finding is the tendency to support the head with the hands when going between the upright and supine position. Paresthesias in the upper extremities and slight exaggeration of muscle stretch reflexes may also occur. Myelopathy may develop in patients with non-union.