Rizvi SAM, Helseth E, Aarhus M, et al. - External immobilization has been the recommended primary treatment for type III odontoid fractures (OFx), except for patients having major displacement of the odontoid fragment. Via performing this retrospective study based on a prospective database, researchers sought to determine the long-term outcome after conservative and surgical treatment of type III OFx as well as to reaffirm that primary external immobilization is the best treatment for most type III fractures. Among 212 consecutive patients with type III OFx (median patient age: 72 years), 56% had severe preinjury comorbidities (ASA score ≥ 3) and 22% lived dependently. Relative to patients treated with primary surgery, those managed with primary external immobilization alone presented with significantly less translation of the odontoid fragment and less angulation of the odontoid fragment.Outcomes overall reaffirm that nonsurgical treatment remains the favorable approach in the majority of patients with type III OFx.