Flexion tear-drop fracture of the axis without neurological deficits


  • Singkat Dohar A. L Tobing Department of Orthopaedic & Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Putri Amalia Isdianto Department of Orthopaedic & Traumatology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia


Tear drop fracture, fracture of C2-C3 vertebrae, without neurological deficit, acute flexion injury, axialcompressive injury, cervical posterior stabilization


Introduction :

Tear drop fracture is a cervical vertebral body fracture that has a triangular- or quadrilateral-shaped fragment that separates from antero-inferior corner and resembles a drop of water dripping from the entire vertebral body. This fracture mostly occurs at C5, C6, and C4 with common neurological injury. However, we found a rare case of C2-C3 tear drop fracture without neurological deficit. We tried to analyze the etiology and biomechanics of injury based on diagnostic images and biomechanical studies.

Methods :

We reported a 40 year-old female with tear drop of C2 and C3 vertebrae. There were history of motorcycle accident, unconsciousness, neck pain and tenderness around her cervical neck. Radiological examination showed a tear drop fracture of the antero-inferior part of C2 vertebral body and fracture of C3. The patient underwent surgery for posterior stabilization using pedicle screws and rods in C2 and C3 vertebrae.


Stable condition and normal neurological status were achieved after surgery and it remained excellent through the time. The patient was able to sit, stand, and walk after 3 days of surgery and was discharged from the hospital 5 days after surgery.


A rare tear drop fracture without neurological deficit in this case was considered to be the result of combination of flexion and axial-compressive injury. Due to its common instability problem following this pattern of injury, we decided to do a surgical procedure to this patient. Further evaluation on this patient gave a very good outcome.


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