Open reduction and plate osteosynthesis is the currently favored technique for C2.2 fractures.

Supporting indications

  • Younger, active patients
  • Older, active patients with good bone quality
  • Markedly severe deformity


  • Supplementary tension band sutures are possible
  • Supplementary tuberosity fixation is possible


  • Risk of damage to the axillary nerve depending on the approach chosen
  • Risk of secondary loss of reduction in cases of severe osteoporosis, persisting varus displacement and medial comminution
  • Technically demanding
  • Possibility of late failure due to avascular necrosis