title: Type II odontoid fracture from frontal impact: case report and biomechanical mechanism of injury.
abstract: The authors report a case of Type II odontoid fracture from a frontal impact sustained in the crash of a late-model motor vehicle. They discuss the biomechanical mechanisms of injury after considering patient demographic data, type and use of restraint systems including seatbelt and airbags, crash characteristics, and laboratory-based experimental studies. Multiple factors contributed to the Type II odontoid fracture: the patient's tall stature and intoxicated state; lack of manual three-point seat belt use; obliqueness of the frontal impact; and the most likely preflexed position of the head-neck complex at the time of impact, which led to contact of the parietal region with the A-pillar roof-rail area of the vehicle and resulted in the transfer of the dynamic compressive force associated with lateral bending. Odontoid fractures still occur in individuals involved in late-model motor vehicle frontal crashes, and because this injury occurs secondary to head impact, airbags may not play a major role in mitigating this type of trauma to an unrestrained occupant. It may be more important to use seat belts than to depend on the airbag alone for protection from injury.
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. yoga@mcw.edu
authors.forename: Narayan
authors.initials: N
authors.lastname: Yoganandan
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Baisden
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Maiman
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pintar
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000435:Alcoholic Intoxication; D001334:Automobile Driving; D001696:Biomechanical Phenomena; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging; D008297:Male; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D014057:Tomography, X-Ray Computed