Download What is your findings?

Common cervical
fractures
Presented by:
Dr fahad albader
Question (1)
e
c
f
a
h
d
i
b
g
j
k
Question (2)
e
g
a
b
c
f
d
Question (3)
• What is the name of
this view?
• What is your findings?
• What is your Dx.?
• What is your next step?
Question (4)
• What is your findings?
• What is your Dx.?
• Is it stable or unstable?
Question (5)
• What is your findings?
• Which ligament is
affected?
• What is your Dx.?
• Is it stable or unstable?
Question (6)
• What is your findings?
• Which ligaments are
affected?
• What is your Dx.?
• Is it stable or unstable?
Question (7)
• What is your findings?
• What is your Dx.?
• What are the most
common sites?
• Is it stable or unstable?
Question (8)
• What is your findings?
• What is your Dx.?
• Which type has the
worst prognosis?
Question (9)
• What is your findings?
• What is your Dx.?
• Is it stable or unstable?
The answers
Question (1)
e
c
f
a
h
b
d
i
g
j
k
Answer (1)
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
Intervertebral disc.
Spinous process.
Transverse process.
Pedicle.
Dense of C2.
Intervertebral disc.
Body of C7.
Facet joint.
Lamina.
Spinous process of C7.
Pedicle.
Question (2)
e
g
a
b
c
f
d
Answer (2)
a.
b.
c.
d.
e.
f.
g.
Dense of C2.
Lateral mass of C1.
Body of C2.
Anterior vertebral line.
Posterior vertebral line.
Spinolaminar line.
Posterior spinous line.
Question (3)
• What is the name of
this view?
• What is your findings?
• What is your Dx.?
• What is your next step?
Jefferson Fracture
• Compression fracture of
the bony ring of C1.
• The key radiographic view
is the AP open mouth.
• Displacement of the lateral
masses of C1 beyond the
margins of the body of C2
(>2mm).
• CT is required.
• It is unstable fracture.
Normal vs abnormal
Jefferson Fracture
Question (4)
• What is your findings?
• What is your Dx.?
• Is it stable or unstable?
Hangman's Fracture
• Radiographic features:
(best seen on lateral view)
1. Prevertebral soft tissue
swelling.
2. Avulsion of anterior inferior
corner of C2 associated with
rupture of the anterior
longitudinal ligament.
3. Anterior dislocation of the
C2 vertebral body.
4. Bilateral C2 pars
interarticularis fractures.
• Unstable fracture.
Question (5)
• What is your findings?
• Which ligament is
affected?
• What is your Dx.?
• Is it stable or unstable?
Flexion Teardrop Fracture
• Radiographic features:
(best seen on lateral view)
1. Prevertebral swelling
associated with anterior
longitudinal ligament tear.
2. Teardrop fragment from
anterior vertebral body
avulsion fracture.
3. Posterior vertebral body
subluxation into the spinal
canal.
4. Spinal cord compression
from vertebral body
displacement.
5. Fracture of the spinous
process.
• Unstable fracture.
Question (6)
• What is your findings?
• Which ligaments are
affected?
• What is your Dx.?
• Is it stable or unstable?
Bilateral Facet Dislocation
• Radiographic features:
(best seen on lateral view)
1. Complete anterior dislocation
of affected vertebral body by half
or more of the vertebral body AP
diameter.
2. Disruption of the posterior
ligament complex and the
anterior longitudinal ligament.
3. " Bow tie" or " bat wing"
appearance of the locked facets.
• Unstable fracture.
Unilateral Facet Dislocation
•
Radiographic features:
(best seen on lateral or oblique views)
1. Anterior dislocation of affected vertebral
body by less than half of the vertebral body
AP diameter.
2. Discordant rotation above and below
involved level.
3. Facet within intervertebral foramen on
oblique view.
4. Widening of the disk space.
5. "Bow tie" or "bat wing" appearance of
the overriding locked facets.
•
Stable fracture.
Bow tie appearance
Question (7)
• What is your findings?
• What is your Dx.?
• What are the most
common sites?
• Is it stable or unstable?
Clay Shoveler's Fracture
• Fracture of a spinous process
C6-T1.
• Radiographic features:
(best seen on lateral view)
1. Spinous process fracture on
lateral view.
2. Ghost sign on AP view (i.e.
double spinous process of C6 or
C7 resulting from displaced
fractured spinous process).
• Stable fracture.
Question (8)
• What is your findings?
• What is your Dx.?
• Which type has the
worst prognosis?
Odontoid Fractures
• Best seen on lateral
view.
• Sometimes the only
sign of fracture may be
just prevertebral soft
tissue swelling.
• fracture line may be
better delineated by CT.
Dens Fracture Type I
• fracture in superior tip of the odontoid.
• It is unstable fracture.
• Rare fracture.
Dens Fracture Type II
• fracture at base of odontoid.
• the most common type.
• Unstable fracture.
Dens Fracture Type II
Dens Fracture Type III
• Fracture through base of odontoid into body
of axis.
• It has the best prognosis.
Question (9)
• What is your findings?
• What is your Dx.?
• Is it stable or unstable?
Burst Fracture
• fracture of C3-C7.
• Injury to spinal cord,
secondary to
displacement of posterior
fragments .
• Common.
• Unstable.
Wedge Fracture
• Radiographic features:
1. Buckled anterior cortex.
2. Loss of height of anterior
vertebral body.
3. Anterosuperior fracture of
vertebral body.
• Stable
Mechanism of Injury
Summery
Type of Injury
Fracture
Flexion
Unilateral facet dislocation
Bilateral facet dislocation
Wedge compression fracture
Flexion teardrop fracture
Clay Shoveler's fracture
Extension
Hangman's fracture
Compression
Jefferson fracture
Burst fracture
Complex
Odontoid
Summary
Stable
Unilateral interfacetal dislocation
Simple wedge fracture
Burst fracture.
Clay Shoveler's fracture
unstable
Bilateral interfacetal dislocation
Flexion teardrop fracture
Hangman's fracture
Jefferson fracture of atlas
Thank you..