Unstable Cervical Fractures


    Unstable Cervical Fractures

    Last pearl before our inservice tomorrow. Good luck to everyone. Hopefully this will buy you an additional point.


    Jefferson Bit Off A Hangman’s Tit = Unstable cervical spine fractures


    Jefferson Fracture

    • A burst fracture of the ring of C1
    • Typically caused by an axial loading force to the occiput (think diving injury)
    • Typically seen with odontoid view, bilateral, lateral offset of C1 on C2

    jeffersonjefferson ct


    Bilateral Locked Facets

    • Severe flexion injury causes subluxation of superior vertebral body forward by 50% compared to inferior vertebral body
    • Both anterior and posterior ligamentous structures disrupted
    • Typically occurs in lower cervical spine (seen on lateral view)

    bit xr         bit ct

    Odontoid Fracture

    • Fracture of the dens of the axis (C2)
    • Really type II (waist) and type III (incl c2 body) are unstable
    • Other fracture seen on Odontoid view (open mouth view)

    off xr    off ct


    Atlanta-occipital dislocation/subluxation

    • Typical fatal, basically head has detached from spine, <1% of injuries
    • More common in children given larger head size
    • Seen on lateral view


    Hangman’s Fracture

    • Hyperextension injury (chin hitting dashboard/windshied in MVC)
    • Best seen on lateral view
    • Anterior dislocation of C2 vertebral body and bilateral C2 pars interartricularis fractures

    Hangman   hangman plain film lateral

    Teardrop Fracture

    • Hyperextension injury caused by the sudden pull of the anterior longitudinal ligament int he anterior/inferior aspect of the vertebral body (typically C2)
    • Best seen on lateral view

    teardrop        teardrop ct


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