A 20-year-old man sustains a diving injury. Open-mouth odontoid view and CT show lateral displacement of the lateral masses of C1 beyond the margins of C2 bilaterally, with no fracture of the dens. The diagnosis is:
- A Hangman's fracture
- B Jefferson fracture ✓
- C Odontoid fracture Type II
- D Clay-shoveler's fracture
Correct answer: B. Jefferson fracture
Explanation
Jefferson fracture is a burst fracture of the C1 ring caused by axial loading, with fractures of both the anterior and posterior arches and lateral displacement of the lateral masses on the open-mouth view. It is usually stable if the transverse ligament is intact. Hangman's fracture is bilateral pedicle/pars fracture of C2. Odontoid fracture involves the dens. Clay-shoveler's fracture is an avulsion of the spinous process of C7 or T1.
Reference: Rockwood and Green's Fractures in Adults, 9th ed.
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Written and medically reviewed by the StethoPrep medical team.