Atlas fracture and dislocation is a more common type of upper cervical spine injury, accounting for about 50%. The neurological symptoms of atlantic fracture and dislocation seen in clinical are different, some patients die on the spot, and some patients are severely ill with different degrees of brain stem and spinal cord injury, manifested as cerebral nerve palsy, quadriplegia or incomplete paralysis And respiratory disorders, often need immediate assistance to breathe, and some only occipital neck pain and movement disorders, neurological symptoms are mild, but such patients are still potentially dangerous, and should be highly valued and treated accordingly. The cause of is mostly caused by the vertical squeezing violence from the head. Clinical manifestations Neck pain and stiffness, patients often hold the head with both hands to avoid their activities. For example, when the second cervical nerve (large occipital nerve) is involved, the patient feels occipital pain, cervical muscle spasm, and limited neck activity. If accompanied by spinal cord injury, there may be loss of motor sensation. Severe injuries can cause paralysis or even immediate death. Examination needs to open X-ray film-lateral X-ray film, and measure on the open film to understand the atlas compression fracture and atlantoaxial instability, the outer edge of the normal atlas lateral mass and the axial articular process The outer edge is on the same straight line, and the bilateral lateral mass of the atlantic vertebrae fracture is displaced outward, and the lateral edge of the lateral mass exceeds the outer edge of the articular process of the axis. Measure the distance of lateral mass displacement outwards, the sum of the two sides exceeds 6.9mm, indicating that the transverse ligament of the atlas ruptures, resulting in atlantoaxial instability. Double fractures of the posterior arch of the atlas can be seen on the lateral X-ray film, and the fracture line passes through the vertebral artery groove. The distance between the mass on both sides of the atlas and the dentate process is equal and symmetrical. The distance between the posterior edge of the anterior arch of the atlas and the anterior process of the dentate, that is, the distance between the atlas and teeth is normally 3mm, which is a relatively constant sign within 3mm. Normal, it may be atlas fracture with transverse ligament rupture. In order to understand the changes in the atherosclerotic area, it is advisable to use tomography and CT scans, which can often show the fracture separation of atlas vertebrae, which is beneficial to determine its stability. Attention should also be paid to the avulsion fracture of the medial margin of the lateral mass of the atlas, because it is a sign of tearing of the transverse ligament, indicating that the fracture is unstable.