An 82-year-old woman falls at home. CT of the cervical spine shows a fracture through the base of the odontoid process, separate from the body of C2. Which statement about this fracture is correct?
- A It has the lowest rate of nonunion among odontoid fractures
- B It extends into the body of the C2 vertebra
- C It carries a high risk of nonunion and often needs operative fixation in the elderly ✓
- D It is classified as Anderson-D'Alonzo type III
Correct answer: C. It carries a high risk of nonunion and often needs operative fixation in the elderly
Explanation
A fracture at the base of the odontoid, above the C2 body, is Anderson-D'Alonzo type II, the commonest and most unstable type. Its blood supply is poor at this site, giving nonunion rates approaching 30 to 50 percent, especially in elderly patients treated conservatively, so early surgical fixation such as anterior screw osteosynthesis or posterior C1-C2 fusion is favoured. Type III extends into the C2 body and unites well.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.