711 March 2013 T image demonstrates a complex C1 fracture reduced via excessive occipital-C1 flexion via halo vest immobilization (fig. A). Note arrow indicating slit-like oropharyngeal space originating below the soft palate. Halo vest immobilization occurred 30 min before emergent surgery for treatment of open femur fractures after a 15-foot fall. Shortly thereafter, the patient became tachyp...