Fractures and
Dislocations: Dens
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Dens
Fractures
of the dens are commonly classified into 3 types with
type II being the most common:
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TYPE 1 -
Avulsion fracture of the tip. It is considered stable, but may
represent detachment of the alar ligament (atlanto-occipital
disassociation). Rare.
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TYPE II -
Fracture at base of ondontoid (poor blood supply kind of like
scaphoid, non-union in 65%).
Most
Common. Poor blood supply. Unstable.
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TYPE III -
Fracture through
base of ondontoid into body of axis: (best prognosis for healing, but
unstable.
Anterior tilt of
ondontoid on lateral view is highly suspicious for fracture.
Prevertebral soft
tissue swelling may be the only sign.
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Dens Type II Fracture (OND view)
Dens Type II Fracture, Lateral View
Dens Type II Fracture on CT
This section written by:
LCDR Ron Boucher, MC, USN
LT Hugh McSwain, MC, USN
With some assistance from:
CDR Michael Puckett, MC, USN
ENS Robert Post, MC, USNR
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Approved for public release;
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Bureau of Medicine and Surgery
Department of the Navy
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Operational Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
United States Special Operations
Command
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MacDill AFB, Florida
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Operational Medicine 2001
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