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Jefferson’s Fracture

  1. It is most common type of atlas fracture .It is cause by axial compression force (with or with out extension force). This mechanism of injury results in a burst fracture of ring of atlas (Cl) vertebrae, that occurs secondary to the occipital condyles being driven into the interior portions of the ring of atlas and driving the lateral masses outwards.
Description: images
  1. Lateral displacement of Cl lateral mass lateral the outer cortex of the C2 lateral mass raises concerns for the structural integrity of the transverse atlantal ligament (TAL). The stability of atlas depends on TAL.
  2. Due to outward movement of lateral masses, there is no encroachment on the neural canal and, usually, no neurological damage.
  3. It is typically diagnosed on plain radiographs
  4. Open mouth (odontoid) view may show asymmetry of the lateral masses of Cl on C2 with overhang.
  5. Coronal C T reformation provides the best method of evaluating important atlas fracture characteristics.
  6. Treatment
    1. The treatment for isolated atlas injuries is typically nonoperative
    2. Undisplaced stable injuries are managed by semi rigid cervical collar or halo- vest until fracture unites.
    3. Unstable injury is managed by halo traction , halovest immobilization for a total of 3 - 4 months.
    4. If a late instability or nonunion is present, atlanto — axial (Cl - C2) arthodesis and atlanto occipital (cervico- occipital) fusion is done
    5. Fracture of atlas are associated with injury elsewhere in cervical spine in upto 50% of cases; odontoid fractures and hangman’s fractures in particular should be excluded.

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