Subdental synchondrosis fracture in children: the value of 3-dimensional computerized tomography

A case is presented illustrating the usefulness of computerized tomography (CT) with 3-dimensional (3-D) reconstruction for evaluation of a subdental synchondrosis fracture in a child. Odontoid fractures in children less than 7 years of age occur at the subdental synchondrosis and are typically diagnosed with plain x-rays. However, a delay in diagnosis is common as these injuries may not be appreciated on initial roentgenographic evaluation. The authors present a case of a 2-year-old boy with a subdental synchondrosis fracture secondary to trauma. In this patient, plain x-ray and conventional axial CT failed to definitively elucidate the child's injuries; however, the use of CT with 3-D reconstruction fully delineated the injury. The use of CT with 3-D reconstruction in evaluating children with subdental synchondrosis fractures is a valuable tool for diagnosis. The treatment of synchondrosis fractures of the odontoid process in children is immobilization of the cervical spine.