P.136 Type III odontoid fracture with C1 and C2 distraction injury manifesting as a variant of occipital-cervical dissociation
Bibliographic record
Abstract
Background: Isolated odontoid type III fractures are usually stable with surgical fixation reserved for significant fracture displacement or inability to maintain alignment with external immobilization. We present a rare but important pattern of injury involving a C2 fracture with C1 and C2 distraction behaving as a variant of occipital-cervical dissociation. Methods: Case Report Results: An 88-year-old female was involved in a motor vehicle accident and was transferred to a trauma centre from a peripheral hospital intubated. She was diagnosed with a significant injury to the C2 vertebral body with distraction between C1 and C2, which is a variant of an occipital-cervical dissociation. This patient had significant facial injuries, a zygomatic fracture, multiple lacerations, and a pulmonary contusion. Her ISS (Injury Severity Score) was greater than 16. She was however from a spine perspective neurologically intact. She required stabilization in the form of an occiput-cervical fusion. Conclusions: We present a polytrauma patient with a C2 distraction type injury and atlantoaxial dissociation manifesting more like an occipital-cervical dissociation injury with very good pre-operative imaging. These injury patterns are critical to recognize as they are unstable requiring occiput-cervical fusion instead of a cervical fusion alone which is reserved for some cases of odontoid Type III fractures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".