Jefferson fracture: Difference between revisions
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==Management== | ==Management== | ||
===Prehospital Immobilization=== | ===Prehospital Immobilization=== | ||
See [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]] | *See [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]] | ||
===Hospital=== | ===Hospital=== | ||
Revision as of 11:24, 17 November 2015
Background
- Also known as a C1 burst fracture
- No ligamentous disruption
- Is an unstable spine injury
Clinical Features
- Fx of the ant AND post arches
- Due to axial loading transmitted through occipital condyles to the lateral masses
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Workup
- 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