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C1 isolated anterior arch fracture
From WikEM
Contents
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
Cervical Spine Fractures and Dislocations
- Atlanto-occipital dissociation
- C1
- Jefferson fracture
- C1 isolated anterior arch fracture
- C1 isolated posterior arch fracture
- C2
- C3-C7
- Cervical facet dislocation
Imaging
- CT test of choice to eval for associated fx'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
