Gehweiler classification of atlas fractures
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The Gehweiler classification of atlas fractures described 5 types of fractures of the atlas. In addition, Dickman classified injuries of the transverse atlantal ligament (a.k.a. transverse band of the cruciform ligament) which has been incorporated into this classification system.
- type 1: fractures of the anterior arch
- type 2: fractures of the posterior arch and are usually bilateral
type 3: fractures involving the anterior and posterior arch (Jefferson burst fracture)
- type 3a: intact transverse atlantal ligament
type 3b: disrupted transverse atlantal ligament complex
- Dickman type 1: ligamentous disruption
- Dickman type 2: bony avulsion with an intact ligament transverse atlantal ligament
- type 4: fractures of the lateral mass
- type 5: isolated fractures of the C1 transverse process
The Rule of Spence has been advocated in the past as a radiographic method to assess for the integrity of the transverse atlantal ligament.
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