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NYCC Bone & Joint > C2 Fractures > Flashcards

C2 Fractures Flashcards

1
Q

What is the mechanism of a hangman fracture?

A

hyperextension without traction
(eg. rear-ended w/unsupportive headrest)

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2
Q

What is the stability of a hangman fracture?

A

unstable

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3
Q

What is the clinical presentation of a hangman fracture?

A
  • often neurologically intact at presentation
  • +/ve Rust sign
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4
Q

What other injuries are associated with a hangman fracture?

A

25% have other hyperextension inj (teardrop Fx)

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5
Q

What is the clinical significance of a hangman fracture?

A

leads to “traumatic spondylolisthesis” of C2

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6
Q

What is a hangman fracture?

A

Fx through C2 pedicles

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7
Q

What is a teardrop fracture?

A

Fx of anterior inferior body of c/s, leaving a small triangular Fx fragment

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8
Q

What is the mechanism of a teardrop fracture?

A

C2-C4 hyperextension
C3-C7 hyperflexion

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9
Q

What structures are damaged in a teardrop fracture of C2?

A

ALL rupture + avulsion of body corner

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10
Q

What structures are damaged in a teardrop fracture of C5?

A

complete posterior ligamentous rupture knocks body corner off (everything but ALL)

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11
Q

What is the stability of a teardrop fracture?

A

unstable
(flexion worse than extension)

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12
Q

What neurologic injury occurs with an extension mechanism teardrop fracture?

A

central cord syndrome:
loss of motion & sensation in upper extremities

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13
Q

What neurologic injury occurs with an flexion mechanism teardrop fracture?

A

anterior cord syndrome:
complete motor paralysis, loss of P&T sensations

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14
Q

What is a type 1 odontoid fracture?

A

avulsion of alar ligament on dens (small piece)

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15
Q

What is the mechanism of a type 1 odontoid fracture?

A

traction injury

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16
Q

What is the stability of a type 1 odontoid fracture?

A

stable

17
Q

What is a type 2 odontoid fracture?

A

Fx at the base of dens
(heals non-union)

18
Q

What is the mechanism of a type 2 odontoid fracture?

A

hyperextension
(often in elderly w/ osteopenia)

19
Q

What is the stability of a type 2 odontoid fracture?

A

unstable
(Guillotine effect)

20
Q

What is a type 3 odontoid fracture?

A

Fx through at least 1 facet of C2

21
Q

What is the mechanism of a type 3 odontoid fracture?

A

hyperflexion OR hyperextension

22
Q

What is the stability of a type 3 odontoid fracture?

A

unstable

23
Q

What is the most common type of odontoid fracture?

A

type 2

24
Q

What is the differential diagnosis for a type 2 odontoid fracture?

A

os odontoideum

25
Q

What is the diagnosis?

A

Type 3 odontoid Fx

26
Q

What is the diagnosis?

A

Hangman Fx

27
Q

What is the diagnosis?

A

Type 2 odontoid Fx

28
Q

What is the diagnosis?

A

Teardrop Fx

29
Q

What is the stability of this diagnosis?

A

Unstable
(Type 2 odontoid Fx)

30
Q

A bilateral pedicle fracture of C2 is noted with a 25% anterolisthesis. What is the diagnosis?

A

Hangman Fx

NYCC Bone & Joint (20 decks)

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