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July 6, 1940


JAMA. 1940;115(1):73. doi:10.1001/jama.1940.02810270075023

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To the Editor:—  The authors of the clinical note "Fracture of the Posterior Arch of the Atlas" (Sinberg, S. E., and Burman, M. S.: The Journal, May 18, p. 1996) present two cases with instructive roentgenograms and follow-up histories.They describe the mechanism of the injury as pressure of the occiput on a "rigid cervical spine with the muscles of the neck relaxed." As a rule muscular fixation seems to be essential in producing a fracture of the atlas in this squeezing action. The authors are kind enough to refer to two short articles of mine on the subject, while the more detailed paper "Fractures of the Atlas Resulting from Automobile Accidents: A Survey of the Literature and Report of Six Cases" (Am. J. Roentgenol.40:867 [Dec.] 1938) apparently has escaped their attention. Sinberg and Burman conclude that fracture of the posterior arch does not seem to be an

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