C1 isolated posterior arch fracture: Difference between revisions
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**Anterior arch and transverse ligament are unaffected | **Anterior arch and transverse ligament are unaffected | ||
*Also called a Landells Atlas Type I fracture | *Also called a Landells Atlas Type I fracture | ||
*Rule out [[Jefferson fracture|burst fracture]] | |||
== | ==Mechanism== | ||
*Due to forced neck extension | *Due to forced neck extension | ||
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{{Cervical spine injuries}} | {{Cervical spine injuries}} | ||
== | ==Imaging== | ||
*Vertical fracture line through posterior arch seen on lateral xray | *Vertical fracture line through posterior arch seen on lateral xray | ||
*CT test of choice to eval for associated fx's | |||
*MRI can evaluate ligamentous injury (transverse ligament is primary AA jxn stabilizer) | |||
==Management== | ==Management== | ||
*Hard collar for 6-12 weeks | |||
**Neurosurgery may prefer Halo immobilization | |||
*Prehospital Immobilization see [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]] | *Prehospital Immobilization see [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]] | ||
==Disposition== | ==Disposition== | ||
*Usually discharge (if truly isolated) in consultation with neurosurgery | |||
==See Also== | ==See Also== | ||
*[[Cervical spine injuries]] | *[[Cervical spine injuries]] | ||
*[[C-Spine X-Ray]] | |||
*[[C1 isolated anterior arch fracture]] | |||
*[[Jefferson fracture]] | |||
==References== | |||
[http://www.orthobullets.com/spine/2015/atlas-fracture-and-transverse-ligament-injuries orthobullets] | |||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
Revision as of 15:58, 3 May 2017
Background
- Stable cervical spine fracture
- Anterior arch and transverse ligament are unaffected
- Also called a Landells Atlas Type I fracture
- Rule out burst fracture
Mechanism
- Due to forced neck extension
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Imaging
- Vertical fracture line through posterior arch seen on lateral xray
- CT test of choice to eval for associated fx's
- MRI can evaluate ligamentous injury (transverse ligament is primary AA jxn stabilizer)
Management
- Hard collar for 6-12 weeks
- Neurosurgery may prefer Halo immobilization
- Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization
Disposition
- Usually discharge (if truly isolated) in consultation with neurosurgery