C1 isolated anterior arch fracture

Background

• Stable Cervical spine fracture
• Also called a Landells Atlas Type I fracture or plough fracture
• Rule out burst fracture

Mechanism

• Axial compression, hyperextension, or lateral compression

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.

Numbering order of vertebrae.

• Cervical fractures and dislocations
  • Atlanto-occipital dissociation
  • C1
    • Jefferson fracture
    • C1 isolated anterior arch fracture
    • C1 isolated posterior arch fracture
  • C2
    • Odontoid fracture
    • Hangman's fracture
  • C3-C7
    • Cervical burst fracture
    • Cervical spinous process fracture
    • Extension cervical teardrop fracture
    • Flexion cervical teardrop fracture
    • Anterior cervical wedge fracture
  • Cervical facet dislocation
  • Isolated transverse process fracture
• Thoracic and lumbar fractures and dislocations
  • Chance fracture
  • Thoracic burst fracture
  • Lumbar burst fracture
  • Isolated transverse process fracture
  • Thoracic and lumbar compression fractures

Imaging

• CT test of choice to eval for associated fracture's
• MRI can evaluate ligamentous injury (transverse ligament is primary AA jxn stabilizer)

Management

• Hard collar for 6-12 weeks
  • Neurosurgery may prefer Halo immobilization
• Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization

Disposition

• Usually discharge (if truly isolated) in consultation with neurosurgery

See Also

• Cervical spine injuries
• C-Spine X-Ray
• C1 isolated posterior arch fracture
• Jefferson fracture

References

• Orthobullets