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May 18, 1940

FRACTURE OF THE POSTERIOR ARCH OF THE ATLAS

JAMA. 1940;114(20):1996-1998. doi:10.1001/jama.1940.62810200001007
Abstract

Statistics show that the "broken neck," as spoken of by the public, is not necessarily or usually fatal.1 Fracture of the bodies of the lower cervical vertebrae, as well as of the atlas, is rarely followed by death. This is not true of fracture of the odontoid process, which is the mechanism of death by hanging. In fractures of the atlas a 13.7 per cent mortality has been reported since 1900.2 The strong transverse ligament that crosses the odontoid posteriorly serves to preserve the normal anatomic relation between the atlas and the surrounding structures, even in fracture of each posterior arch.

The rarity of fracture of the atlas is attested by the fact that only ninety-three cases had been reported to 1938.1a Situated at the base of the skull and surrounded by strong bundles of muscle, the atlas is rarely fractured as the result of a direct

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