Fracture of the pivot tooth, is the most common and also the most dangerous case of cervical spine fractures encountered in the elderly. The danger of permanent disability, or even death, is due to the proximity to the medulla oblongata and the risk of displacement of the bone fragment. Treatment can be conservative, in the form of the use of a stiffening collar, but the main method of treatment is surgery, undertaken in any case where there are no medical contraindications in the patient.