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Classic Metaphyseal Fracture of Abuse
Joseph Junewick, MD FACR
over 5 years ago
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Avulsion Fracture of the Anterior Atlas

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CT
Activities:
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History

5 year old restrained backseat passenger involved in high speed head-on motor vehicle collision.


Case Images


Diagnosis

Avulsion Fracture of the Anterior Atlas

Clinical Notes

Hyperflexion distraction injury of L3 (Chance fracture), L1 spinous process avulsion fracture, duodenal injury and mid-small bowel/mesentery injury.

Findings

CT – Sagittal and coronal reformats demonstrate fracture of the inferior aspect of the anterior arch of C1. Note the anterior convex prevertebral soft tissue swelling inferior to the arch of C1.

Discussion

Fractures of the inferior aspect of the anterior arch of C1 occurring in the axial plane are the result of hyperextension and disruption of the anterior atlantoaxial ligament and/or longus colli muscles. The anterior atlantodental interval is normal although prevertebral soft tissue swelling is often present. The injury is not associated with neurologic deficit and heals without incident.

Reference

Harris JH and Mirvis SE. The Radiology of Acute Cervical Spine Trauma. 3rd Ed (1996).



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