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Odontoid fracture biomechanics
1From the Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT.
Spine
|October 2, 2014
Summary
Midline forehead impacts can cause odontoid fractures by rapidly decelerating the head, leading to neck injuries. Lateral head impacts did not produce these fractures in biomechanical simulations.
Area of Science:
- Orthopedic biomechanics
- Trauma research
- Spinal injury mechanisms
Background:
- Odontoid fractures are common in younger adults from high-energy trauma and in older adults from falls.
- Understanding fracture mechanisms is crucial for injury prevention and treatment.
Purpose of the Study:
- To investigate the biomechanical mechanisms underlying odontoid fractures.
- To determine the relationship between head impact location and odontoid fracture occurrence.
Main Methods:
- An in vitro biomechanical study using human upper cervical spine specimens (occiput-C3).
- Simulated horizontally aligned head impacts into a padded barrier on a sled system.
- Specimens were grouped by impact location: midline forehead, lateral forehead, and lateral head.
Main Results:
- Midline forehead impacts caused Type II or high Type III odontoid fractures in 4 out of 5 specimens.
- These fractures resulted from head deceleration and torso momentum, causing neck forces up to 1787.1 N.
- Lateral head impacts did not result in odontoid fractures.
Conclusions:
- Midline forehead impact is a significant mechanism for producing odontoid fractures and associated injuries.
- The mechanism involves rapid head deceleration, inferior load transfer, and spinal compression with anterior shear.
- Lateral head impacts do not appear to replicate the forces leading to odontoid fractures.
