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Difficulty: Very hardOrthopedic Surgery

Match each traumatic cervical spine fracture to its most characteristic mechanism of injury, primary structural finding, and major clinical consequence.

  • Jefferson fractureSevere axial loading; C1 ring burst fracture best viewed on an open-mouth radiograph.
  • Hangman fractureHyperextension and distraction; bilateral C2 pars interarticularis fractures, paradoxically widening the spinal canal.
  • Flexion teardrop fractureExtreme hyperflexion and compression; highly unstable disruption of the posterior ligamentous complex, strongly associated with anterior cord syndrome.
  • Type II Odontoid fractureFlexion or extension shear; transverse fracture at the base of the dens with a high risk of nonunion due to watershed vascularity.

Answer

Jefferson fracture pairs with the C1 burst from axial loading. Hangman fracture pairs with C2 pars interarticularis fractures from hyperextension. Flexion teardrop pairs with the highly unstable hyperflexion injury causing anterior cord syndrome. Type II Odontoid pairs with the dens base fracture prone to nonunion.
Each named cervical fracture corresponds strictly to a unique mechanism of injury, anatomical failure point, and prognostic outcome. The Jefferson (C1 burst/axial), Hangman (C2 pars/hyperextension), Flexion teardrop (hyperflexion/instability), and Type II Odontoid (dens base/nonunion) pairs correctly reflect classical orthopedic trauma principles.

Step-by-Step Solution

1
Analyze the Jefferson fracture pattern.
Identified as a C1 burst fracture.
Axial loading drives the occipital condyles into the lateral masses of C1, bursting the ring outward.
2
Analyze the Hangman fracture pattern.
Identified as bilateral C2 pars interarticularis fractures.
Hyperextension causes traumatic spondylolisthesis, which widens the central canal and often mitigates immediate spinal cord compromise.
3
Analyze the Flexion teardrop fracture pattern.
Identified as a complete posterior ligamentous disruption with an anterior body fragment.
Hyperflexion forces the vertebral body posteriorly into the canal, making it extremely unstable and highly associated with anterior cord syndrome.
4
Analyze the Type II Odontoid fracture pattern.
Identified as a fracture through the base of the dens.
The base of the dens is a vascular watershed area, predisposing this specific fracture pattern to a high rate of nonunion.

Key Concept

Traumatic Cervical Spine Fracture Patterns
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Topics

Orthopedic Surgery

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