Jefferson fracture: Difference between revisions

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==Clinical Features==
==Clinical Features==
*Fx of the ant AND post arches
*Fx 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  


[[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==
{{Cervical spine injuries}}
{{Cervical spine injuries}}

Revision as of 08:49, 19 December 2015

Background

Clinical Features

  • Fx of the anteterior and posterior arches[1]
    • Due to axial loading transmitted through occipital condyles to the lateral masses
Axial CT scan of Jefferson fracture
Odontoid View

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.
Numbering order of vertebrae.

Diagnosis

  • 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

  1. 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.