The treatment of odontoid fractures is determined by multiple factors, including fracture type, presence of associated injuries, patient age, and patient comorbidities. However, some type I injuries can be seen in association with occipito-atlantal dislocation; and some type III fractures can be closer to the neck of the odontoid (high and shallow based), and may act like a type II fracture, that is, with an increased probability of non-union. Direct osteosynthesis is a method of choice for most of the type II and indicated cases of type III fractures of the odontoid process of the axis. This surgical procedure facilitates restoration of anatomical conditions of the spine and its immediate stability. Consequently, patients can be readily mobilized and rehabilitated.