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CHAPTER 11
odontoid with rupture and displacement of the dens of the axis. The spinal cord showed
profound squeezing effects with destruction of the neural elements and haemorrhages
mainly at the level of €3/4 segments, but extending upwards to Ci and downwards into
the 6th cervical segment. This fracture is commonly called hang-man fracture.
On the other hand, in one of our own patients aged 20, who sustained a fracture
dislocation of Li vertebra and fracture of transverse processes L2 resulting in an incom
plete cauda equina lesion with considerable recovery of motor, sensory, bladder, and
sexual functions, a fracture of the odontoid process with separation through the pedicles
and rotation of the atlas was found. There were no motor or sensory disturbances in the
upper limbs or part of the body above the cauda equina lesion—only the arm reflexes
were found exaggerated without interfering with the isolated movements of the muscles.
Conservative treatment without skull traction was applied and the C2 fracture consoli
dated satisfactorily with a spontaneous anterior fusion between C2 and C3. Figs. 463
and b demonstrate the severe fracture of the odontoid with separation of the dens axis
(a-p picture).
(c) DISLOCATIONS AND FRACTURES OF C3~C7 VERTEBRAE
(i)
Subluxation
Subluxations without fracture may be unilateral resulting in rotation or tilting of the
head to one side (Stimson & Swinson, 1934). Fig. 47 demonstrates a subluxation of the
mid-cervical spine on the 5th cervical vertebra with forward flexion in a man, aged 51,
57.
8
FIG. 47.
57.
25 • 4 •
57.
