What's the diagnosis? By Dr. Lynn Manganiello
A 75 yo male presents with neck pain after rollover MVC. He is awake an alert, hemodynamically stable, with a normal neurological exam. He has a hematoma over the parietal scalp and he has been immobilized in a Philadelphia cervical collar. CT of the cervical spine is shown. What's the diagnosis? Scroll down for answer.
Jefferson (C1) Burst Fracture
- unstable fracture often caused by axial load
- majority of patients will have normal neuro exam
- diagnosed by cat scan cervical spine; x-ray open mouth odontoid view
- most require rigid collar or halo brace and heal without surgical intervention
- clinical pearls
- 50% have additional vertebral fractures
- evaluate with CT angiogram of the neck to assess for concomitant vascular injury
References: Nelson, M. (2019). Cervical Spine Trauma. In S. Sherman (Author), Simon's Emergency Orthopedics (8thed.). McGraw-Hill Education.