Fracture of the odontoid process in young children is possibly not as
rare as hitherto believed. In this paper, two more patients with this
fracture are presented, and an important diagnostic clinical sign is
described. Both patients sustained the injury by falling from heights no
greater than sixty-one to ninety-one centimeters. In each instance, injury
to the cervical spine was suspected but initial roentgenograms failed to
reveal any fracture. The patients were quite comfortable when lying supine
and when fully erect. Each child strongly resisted any attempt at extension
of the neck and cried bitterly when brought to either the erect or the
recumbent position unless the head was passively supported. This a valuable
clinical sign when injury to the odontoid process is suspected. Subsequent
roentgenograms confirmed the diagnosis in each instance.