You are here

Atlas Fracture S12.000A

   

synonyms:Jefferson fracture, C1 fracture, Burst fracture, lateral mass fracture, first cervical vertebra fracture

Atlas Fracture ICD-10

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

    • Occipital Condyle Fracture
    • Occipitocervical Dissociation
    • C2 fracture
    • Odontoid fracture

    Atlas Fracture Complications

    Atlas Fracture Follow-up Care

    Atlas Fracture Review References

    Disclaimer

    The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer