Unilateral C1 Sagittal Split Fractures: An Unusual Entity Revisited

An isolated, unilateral fracture of the C1 lateral mass is a rare condition that has been only minimally described in the literature. Historically, these fractures have predominantly been managed conservatively with either external immobilization or traction.

We review the literature and present 2 patients that presented after failing conservative management, but demonstrated excellent clinical outcomes after surgical treatment.

After failure of conservative management, unilateral sagittal split fractures may be safely and effectively managed with unilateral open reduction and placement of a lag screw.