Fracture of the anterior arch of the atlas: the result of direct oropharyngeal trauma.

Isolated anterior arch atlantal fracture is a rare entity. Two cases of fracture of the atlas following direct oropharyngeal trauma are presented. The importance of careful upper cervical spine evaluation under these circumstances is emphasised, especially if a potential disaster following anaesthetic intubation or surgical head manipulation is to be avoided. Computed tomographic scanning is useful not only to demonstrate the site of fracture but also for visualisation of the spinal canal, especially to exclude intracanalicular bony fragments. The risk of further trauma is minimised due to the ease of patient positioning.