Low Force Fracture of the Odontoid, with Discussion of High Force Cervical Fracture

Abstract

Cervical fracture may occur with a high force mechanism of injury such as a motor vehicle crash, or with a low force mechanism of injury such as a ground level fall. To better characterize and understand low force cervical fractures and their significance, case files from the Travis County Medical Examiner's office covering a 5-year time period were retrospectively reviewed for fatal cervical fracture occurring with an accidental ground level fall. Thirty such fatal cervical fractures were identified, all occurring in elderly individuals (>65 years of age), with odontoid type 2 fracture of the C2 vertebra identified as the most frequent type of fracture. Odontoid fracture should be included in the list of craniocervical injury that may result from not only motor vehicle crashes and other high force mechanisms of injury, but also low force mechanisms of injury such as a ground level fall with head impact in an elderly individual.