C1 (Atlas) fracture

Case contributed by Kumar V M Ramavathu


Skiing accident, fell and head hit a stone. Pain and clicking sensation in the neck since the injury.

Patient Data

Age: 60 years
Gender: Male

CT cervical spine


Comminuted fracture involving the right anterior arch and right lateral mass of the atlas vertebra. C1-C2 alignment is intact. No pre/paravertebral hematoma.

Case Discussion

Atlas fractures account for a quarter of total craniocervical injuries. The most common patterns are bilateral fractures involving the posterior arches and burst fractures. Isolated anterior arch fractures are relatively uncommon. The case described above is a unilateral fracture involving the right anterior arch which extends to the right lateral mass. Atlas fractures are classified using the Jefferson classification. These fractures are usually mechanically stable and rarely cause neurological injury. 

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