Jefferson fracture: Difference between revisions
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*No ligamentous disruption | *No ligamentous disruption | ||
*Is an [[unstable spine fractures|unstable spine injury]] | *Is an [[unstable spine fractures|unstable spine injury]] | ||
{{Vertebral fractures and dislocations types}} | |||
==Clinical Features== | ==Clinical Features== | ||
* | *Fracture of the anteterior and posterior arches<ref> Jefferson, G. (1919) ‘Fracture of the atlas vertebra. Report of four cases, and a review of those previously recorded’, British Journal of Surgery, 7(27), pp. 407–422.</ref> | ||
**Due to axial loading transmitted through occipital condyles to the lateral masses | **Due to axial loading transmitted through occipital condyles to the lateral masses | ||
*Frequently associated with other cervical fractures | |||
*May be associated with vertebral artery injury<ref>Muratsu H, Doita M, Yanagi T et-al. Cerebellar infarction resulting from vertebral artery occlusion associated with a Jefferson fracture. J Spinal Disord Tech. 2005;18 (3): 293-6.</ref> | |||
[[File:Jefferson fracture CT.jpg|thumb|Axial CT scan of Jefferson fracture]] | [[File:Jefferson fracture CT.jpg|thumb|Axial CT scan of Jefferson fracture]] | ||
[[File:Jeffersonfxodontoid.jpg|thumbnail|right|Odontoid View]] | [[File:Jeffersonfxodontoid.jpg|thumbnail|right|Odontoid View]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{ | {{Blunt neck trauma DDX}} | ||
== | ==Evaluation== | ||
*Suspect disruption if: | *Suspect disruption if: | ||
**Lateral x-ray: Increase in the predental space between C1 and dens (>3mm in adults, >5mm in children) | **Lateral x-ray: Increase in the predental space between C1 and dens (>3mm in adults, >5mm in children) | ||
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*[[Unstable spine fractures]] | *[[Unstable spine fractures]] | ||
*[[Cervical spine injuries]] | *[[Cervical spine injuries]] | ||
==References== | |||
<references/> | |||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Category: | [[Category:Orthopedics]] | ||
Latest revision as of 13:16, 24 October 2020
Background
- Also known as a C1 burst fracture
- No ligamentous disruption
- Is an unstable spine injury
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Clinical Features
- Fracture of the anteterior and posterior arches[1]
- Due to axial loading transmitted through occipital condyles to the lateral masses
- Frequently associated with other cervical fractures
- May be associated with vertebral artery injury[2]
Differential Diagnosis
Neck Trauma
- Penetrating neck trauma
- Blunt neck trauma
- Cervical injury
- Neurogenic shock
- Spinal cord injury
Evaluation
- Suspect disruption if:
- Lateral x-ray: Increase in the predental space between C1 and dens (>3mm in adults, >5mm in children)
- Odontoid x-ray: Masses of C1 lie lateral to outer margins of articular pillars of C2
- If either of the above findings on x-ray obtain CT C-spine
Management
Prehospital Immobilization
Hospital
- Degree of instability determined by whether or not the transverse ligament is disrupted
- C-collar
- Consult ortho or spine as needed
Disposition
- Admit
See Also
References
- ↑ Jefferson, G. (1919) ‘Fracture of the atlas vertebra. Report of four cases, and a review of those previously recorded’, British Journal of Surgery, 7(27), pp. 407–422.
- ↑ Muratsu H, Doita M, Yanagi T et-al. Cerebellar infarction resulting from vertebral artery occlusion associated with a Jefferson fracture. J Spinal Disord Tech. 2005;18 (3): 293-6.