Normal alignment of lateral masses and superior facets of C2
Displaced lateral masses on C1 with respect to the superior facets on C2
This image shows a fracture to the anterior arch of C1
The bottom image shows the classsic Jefferson fracture where both anterior and posterior arches of C1 are fractured on both the right and left sides.
What kind of fracture is this?
This fracture involves cervical vertebra number one or the Altas. This fracture classically presents itself as having right and left side breaks on both the anterior and posterior arches of C1 for a total of 4 fractures of C1, but can present with varied numbers of breaks on either side of the anterior and posterior arches depending on how the force is exerted to the head. This type of fracture is also called a burst fracture. This type of fracture is an axial compression fracture where the force of the trauma or injury initiates from a superior or anterior aspect of the skull and then transmits to the cervical spine causing damage. The damage occurs when the downward force compressed C1 onto C2. Some of the more common examples of how these fractures occur are from diving into a shallow pool of water where the head strikes the bottom of the pool, motorcycle accidents where the head strikes the windshield causeing hyperextension and compression, and also falling down onto the head at a decent height.
What kinds of symptoms to patients present with this type of fracture?
-upper neck pain
-there is usually no neurological symptoms displayed initially but if not treated this can cause severe neurological problems if fracture is not stablized
Diagnosis?
-plain film xrays initially taken (open mouth is usually the best image to show the bilateral offset of C1 onto C2)
-CT (Demonstrates the number of fractures and their locations and the degree of displacement of bone fragments)
Treatment?
-Depends on the severity and the stability of the fractures
-The stability of the injury depends on how intact the ligaments are between the vertebra and will determine if surgery is needed to stabilize the fractures
References
No comments:
Post a Comment