Hyperflexion Injuries
- simple wedge compression fx
- bilateral facet dislocation
- flexion teardrop fx
- clay shoveler’s fx
- anterior subluxation
- dens fx
Hyperflexion + rotation injuries
- unilateral facet dislocation
- unilateral facet fx-dislocation
Hyperextension injuries
- C1 posterior arch fx
- dens fx
- hangman’s fx
- C1 anterior tubercle avulsion
- hyperextension fx-dislocation
- hyperextension dislocation
- extension teardrop fx
- lamina fx
Hyperextension + rotation injuries
- pillar fx
- pedicolaminar fx
Vertical compression injuries
- jefferson’s fx of C1
- bursting fx of lower cervicals
Lateral flexion injuries
- TVP fx
- uncinate fx
- unilateral fx lateral mass C1
MC areas of spinal trauma
C1-C2
C5-C7
T12-L1
Davis Series
- lateral
- APOM
- AP cervical
- Lt & Rt obliques
- flexion/extension
- swimmers
What makes a fx unstable?
if more than one column or the middle column is involved and/or neurologically compromised
How long does it take spinal fractures to heal?
3-6 months
Body fractures heal more with ___?
fibrosis
Arch fractures heal more with ___?
callus
What is the MC fracture of atlas?
posterior arch fx, usually bilateral and vertical
What is a Jefferson’s fx?
- bursting fx of C1
- bilateral fx of posterior and anterior arch
What dictates a Jefferson’s fx unstable?
if the lateral mass offset is >7mm
What view is best to fully evaluate the ADI?
flexion
What is the MC type of odontoid fx?
type II (high dens)
What is one finding found in type III odontoid fxs?
disruption of Harris’ ring
Until what age is an os terminale present?
age 12
Why are type II odontoid fxs more common?
due to the decreased amount of trabeculation at the base of the dens
What are some findings present with a NEW compression fx?
- line of impactin
- step defect
- fx line
- blurry or hazy endplates
How does a new compression fx show up on a T1 and T2 MRI?
dark on T1
bright on T2
What are some findings of a lower cervical burst fracture?
- large anterior fragment
- retropulsion of posterior fragment
Bow tie sign is seen in ___?
unilateral facet dislocation
Where are bilateral facet dislocations MC seen at?
C4-C7
What is the most severe injury of the cervical spine?
flexion teardrop fx
What differentiates a flexion teardrop fx from a burst fx?
facet dislocation seen in flexion teardrop fx
What segments are Clay Shoveler’s Fractures seen at?
C6, C7, T1
Where do most T/L fxs occur?
T11-L2
What type of fx is the MC in T/L region?
compression
What are three possible etiologies of a pathological compression fx?
osteoporosis
lytic mets
multiple myeloma
Where are Chance fxs MC seen?
L1-L3
What is a finding associated with Chance fxs?
empty vertebra sign
ghost vertebra sign
What is Chance fx?
horizontal splitting of arch and body
What is the second MC lumbar fx?
TVP fx
Where are TVP fxs MC seen?
L2 & L3
Muscle associated with ASIS avulsion fx
sartorius
Muscle associated with AIIS avulsion fx
rectus femoris
Muscle associated with ischial tuberosity avulsion fx
hamstrings
Muscle associated with lesser trochanter avulsion fx
iliopsoas
What is a Duverney fx?
iliac wing fx
What is the MC fx of the pelvis?
ischiopubic rami fx
What is a Malgaigne fx?
superior and inferior pubic rami fx with a fx or dislocation of SI on the SAME side
What is a Bucket-Handle fx?
superior and inferior pubic rami fx with a fx or dislocation of SI on the OPPOSITE side
What is a Straddle fx?
bilateral superior and inferior pubic rami fx
What is a Sprung fx?
diastasis of pubic symphysis and one or both SI joints
