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Paul J. Apostolides, Nicholas Theodore, Dean G. Karahalios and Volker K. H. Sonntag

✓ The authors report the successful treatment of an acute combination atlas—axis fracture in an 85-year-old man using anterior odontoid and C1–2 transarticular facet screw fixation and a Philadelphia collar. Treatment with halo brace immobilization failed, and the patient experienced recurrent episodes of oxygen desaturation when placed partially prone for chest physiotherapy. If a posterior approach is not feasible, an anterior odontoid and C1–2 transarticular facet screw fixation can be considered as a salvage procedure for patients with acute combination atlas—axis fractures.

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