Objective    To evaluate the application and efficacy of direct anterior fixation of odontoid fractures with hollow screw．    Methods    From March 2001 to January 2006，13 patients with odontoid fractures were treated by direct anterior fixation with hollow screw．    Results    Of the 13 patients，except 2 patients with postoperative temporary dysphagia

11 had excellent results．The follow-up was ranged from 9 to 18 months，with an average of 12.5 months．The odontoid fractures acquired fusion，and no unstability or pseudoarthritis was found．     Conclusion    The technique of direct anterior fixation with hollow screw is an efficacious means in the treatment of odontoid fractures．The meticulous surgical technique along with appropriate patients selection will be the key to successful surgery.