Atlas_Fracture_&_Transverse_Lig

Question 1

Associated atlas injuries

Answer 1

50% associates spine injury

40% associated axis fracture

Question 2

Landells Atlas Fracture Classification

Answer 2

Type I - isolated anterior or posterior arch fracture. A “plough fracture” is an isolated anterior arch fracture from the odontoid forced anteriorly. Stable - collar.

Type II - Jefferson bilateral ant-posterior arch fractures from axial load. Stability determined by transverse ligament integrity. If stable then collar. Transverse ligament disrupted, halo for bony avulsion, C1-2, fusion for intrasubstance tear.

Type III - unilateral lateral mass fracture. Stability depends on transverse ligament. If stable then collar else halo vest.