Atlas Fracture
synonyms:Jefferson fracture, C1 fracture, Burst fracture, lateral mass fracture,
Atlas Fracture ICD-9
Atlas Fracture Etiology / Epidemiology / Natural History
- Typically high energy trauma
Atlas Fracture Anatomy
Atlas Fracture Clinical Evaluation
- Palpate entire spine for tenderness / step off.
- Complete neuro exam: motor strength, pin-prick sensation, reflexes, cranial nerves, rectal examination (perineal pin-prick sensation, sphincter tone, volitional spincter control)
- Absence of the bulbocaverosus reflex indicates spinal shock. Level of spinal injury can not be determined until bulbocaverosus reflex has returned.
- See ASIA form.
- Burst fractures: pain when nodding the head
Atlas Fracture Xray / Diagnositc Tests
- A/P, Lateral, Odontoid views:
- CT cervical spine:
- MRI:
- Burst fractures demonstrate bilateral symmetric overhang of the lateral masses of the atlas in relation ot the axis. Open month view demonstrates increased paradontoid space
Atlas Fracture Classification / Treatment
- Isolated anterior Arch, Posterior Arch, lateral mass fracture
-Treatment = orthosis x 6-12 weeks
- Jefferson burst fracture:
-Stable if combined lateral overhand of the atlas <7mm. Treatment = orthosis or halo x 12 weeks.
-Unstable if transverse diameter of the atlas is >7mm greater then that of the axis, transverse ligament rupture should be suspected. Treatment = C1-2 fusion with Magerl screws or Harms technique.
Atlas Fracture Associated Injuries / Differential Diagnosis
Atlas Fracture Complications
Atlas Fracture Follow-up Care
Atlas Fracture Review References
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