Flexion cervical teardrop fracture

Background

• Is an unstable spine injury

Vertebral fractures and dislocations types

Vertebral anatomy.

Numbering order of vertebrae.

• Cervical fractures and dislocations
  • Atlanto-occipital dissociation
  • C1
    • Jefferson fracture
    • C1 isolated anterior arch fracture
    • C1 isolated posterior arch fracture
  • C2
    • Odontoid fracture
    • Hangman's fracture
  • C3-C7
    • Cervical burst fracture
    • Cervical spinous process fracture
    • Extension cervical teardrop fracture
    • Flexion cervical teardrop fracture
    • Anterior cervical wedge fracture
  • Cervical facet dislocation
  • Isolated transverse process fracture
• Thoracic and lumbar fractures and dislocations
  • Chance fracture
  • Thoracic burst fracture
  • Lumbar burst fracture
  • Isolated transverse process fracture
  • Thoracic and lumbar compression fractures

Clinical Features

• Severe flexion > vertebral body colliding with the one below (shallow water diving injury, MVC deceleration)
• Most commonly at C5-C6
  • Displacement of teardrop shaped fragment of antero-inferior portion of superior vertebra
  • Leads to posterior displacement of vertebral body and disruption of posterior longitudinal ligament
• Frequently occurs with spinal cord injury
  • Associated with acute anterior cervical cord syndrome

Differential Diagnosis

Neck Trauma

• Penetrating neck trauma
• Blunt neck trauma
  • Vertebral and carotid artery dissection
  • Strangulation
  • Whiplash injury
• Cervical injury
  • Cervical fractures and dislocations
  • Cervical injury (peds)
  • Cervical spine clearance
• Neurogenic shock
• Spinal cord injury

Evaluation

• Cervical xrays or CT

Management

Prehospital Immobilization

See NAEMSP National Guidelines for Spinal Immobilization

Hospital

• C-collar
• Consult ortho or spine as needed

Disposition

• Admit

See Also

• Cervical spine injuries