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Erschienen in: Clinical Orthopaedics and Related Research® 5/2008

01.05.2008 | Case Report

Case Report

Nonoperative Treatment of an Unstable Jefferson Fracture Using a Cervical Collar

verfasst von: Brian M. Haus, MD, Mitchel B. Harris, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 5/2008

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Abstract

The treatment of unstable burst fractures of the atlas (Jefferson fractures) is controversial. Unstable Jefferson fractures have been managed successfully with either immobilization, typically halo traction or halo vest, or surgery. We report a patient with an unstable Jefferson fracture treated nonoperatively with a cervical collar, frequent clinical examinations, and flexion-extension radiographs. Twelve months after treatment, the patient achieved painless union of his fracture. The successful treatment confirms prior studies reporting unstable Jefferson fractures have been treated nonoperatively. The outcome challenges the clinical relevance of treatment algorithms that rely on the “rules of Spence” to guide treatment of unstable Jefferson fractures and illustrates instability may not necessarily be present in patients with considerable lateral mass widening. Additionally, it emphasizes a more reliable way of assessing C1–C2 stability in unstable Jefferson fractures is by measuring the presence and extent of anterior subluxation on lateral flexion and extension views.
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Metadaten
Titel
Case Report
Nonoperative Treatment of an Unstable Jefferson Fracture Using a Cervical Collar
verfasst von
Brian M. Haus, MD
Mitchel B. Harris, MD
Publikationsdatum
01.05.2008
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 5/2008
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-008-0143-5

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