![]() ![]() ![]() A fat-sat T2 sequence is useful in the trauma setting to help distinguish abnormal soft-tissue injury from normal fat. A ligamentous injury will also be demonstrated. Pre-vertebral hemorrhage or edema will identify injury at the level of C1/2. However, localized soft-tissue injury will be apparent. The fracture will not be seen as well as with CT. The normal ADI in the adult population is less than 3 mm in pediatric populations, the normal distance is less than 5 mm. If there is an injury to the transverse atlantal ligament, the atlantodental interval (ADI) increases. CTĬT demonstrates the fracture line which usually involves both the anterior and posterior arches. A distance of greater than 6 mm suggests ligamentous injury. Radiographs will show asymmetry in the odontoid view with the displacement of the lateral mass(es) away from the odontoid peg (dens). Disruption of the transverse atlantal ligament (transverse band of the cruciform ligament) was also described by Dickman and incorporated into classifying these injuries. The Gehweiler classification describes injuries of the atlas with a burst or type 3 injury defining the pattern seen in a Jefferson fracture. The Jefferson fracture is not normally associated with neurological deficit although spinal cord injury may occur if there is a retropulsed fragment affecting the cervical cord. Axial loading along the axis of the cervical spine results in the occipital condyles being driven into the lateral masses of C1. vertebral artery injury 5 ( blunt cerebrovascular injury (BCVI))Ī typical mechanism of injury is diving headfirst into shallow water.25-50% of young children have a concurrent head injury.50% are associated with other C-spine injuries.The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. This is particularly important when the recommended agent is a new and/or infrequently employed drug.ĭisclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.ĭrug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. It underlines their benign character and favorable outcome with full functional recovery without any surgical intervention.Ĭopyright: All rights reserved. In this rare case of a Jefferson fracture in a child monitored by radiological imaging techniques, important aspects of conservatively treated atlas burst fractures are illustrated. ![]() Complete fusion of both fracture sites was seen on the third follow-up 6.5 months after presentation. The patient was placed in a rigid cervical collar, and his physical examination results remained normal according to age. The initial radiological characteristics are presented on magnetic resonance imaging (MRI) and computer tomography (CT) the bony bridging and fusion of the fracture sites are demonstrated on CT during the course of the healing. We describe a case of a Jefferson fracture in a 7.5-year-old-boy after falling onto the top of his head, presenting solely with slight neck pain. They all showed a highly consistent clinical presentation with rare neurological deficits as well as recovery with full function without any surgical intervention. In the pediatric population, they are extremely rare, and only few cases have been reported so far. In adults, atlas burst fractures (Jefferson fractures) are not uncommon.
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