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FIGURE 112.27 Distraction injuries A: Dens fractures with distraction and accompanying C6– C7 distraction injury in a 3-year-old child Injury was fatal B: C6–C7 distraction injury in an 8year-old child C : BC (4.5 line): AO (4.0 line) ratio is more than 1, suggesting atlantooccipital dislocation