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
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)
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)
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
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
