Difference between revisions of "Unstable spine fractures"

(Text replacement - "Category:Neuro" to "Category:Neurology")
(Examples of Unstable Fractures)
 
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**Posterior elements
 
**Posterior elements
  
==Clinical Features==
+
===Examples of Unstable Cervical Spine Fractures===
*I:Always stable
 
*II:Possibly unstable
 
*III:Always unstable
 
 
 
==Example of Unstable Fractures==
 
 
*[[Jefferson's fracture]]
 
*[[Jefferson's fracture]]
 
*Bilateral [[Cervical facet dislocation]]
 
*Bilateral [[Cervical facet dislocation]]
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*''Mnemonic: "Jefferson Bit Off A Hangman's Thumb"''
 
*''Mnemonic: "Jefferson Bit Off A Hangman's Thumb"''
  
==Workup==
+
==Clinical Features==
 +
*I:Always stable
 +
*II:Possibly unstable
 +
*III:Always unstable
 +
 
 +
==Evaluation==
 
*CT with reconstructions
 
*CT with reconstructions
*Consider plain x-ray in conjunction as this is what is used during orthospine f/u
+
*Consider plain x-ray in conjunction as this is what is used during orthospine follow up
 
*MRI to assess cord and ligament damage
 
*MRI to assess cord and ligament damage
  
 
==Management==
 
==Management==
 
{{Unstable cervical spine fracture management}}
 
{{Unstable cervical spine fracture management}}
 +
 +
==Disposition==
  
 
==See Also==
 
==See Also==
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*[[Fractures (Main)]]
 
*[[Fractures (Main)]]
  
==Sources==
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==References==
 
<references/>
 
<references/>
  
 
[[Category:Trauma]]
 
[[Category:Trauma]]
 
[[Category:Neurology]]
 
[[Category:Neurology]]
[[Category:Ortho]]
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[[Category:Orthopedics]]

Latest revision as of 13:41, 23 August 2017

Background

Three-column-concept-2.jpg

Denis' three column concept helps to determine whether a vertebral fracture is stable or unstable

  • I: Anterior column
    • Anterior longitudinal ligament
    • Anterior 1/2 of the vertebral body and disk
  • II: Middle column
    • Posterior 1/2 of the vertebral body and disk
    • Posterior longitudinal ligament
  • III: Posterior column
    • Facet joints
    • Ligament flavum
    • Posterior elements

Examples of Unstable Cervical Spine Fractures

Clinical Features

  • I:Always stable
  • II:Possibly unstable
  • III:Always unstable

Evaluation

  • CT with reconstructions
  • Consider plain x-ray in conjunction as this is what is used during orthospine follow up
  • MRI to assess cord and ligament damage

Management

  • C-collar
  • Consult ortho or spine as needed

Disposition

See Also

References