Peg and lateral mass C1 fractures

Case contributed by Dr Craig Hacking

Presentation

MBA.

Patient Data

Age: 24
Gender: Male

There is a slightly posteriorly displaced transverse type III fracture of the odontoid process of C2. Associated prevertebral soft tissue swelling. There is widening of the right atlanto-occipital joint and suggestion of an associated fracture of the posterior right lateral mass of C1, best appreciated on the sagittal projection. Bilateral C7 cervical ribs, with the left rib fused to the transverse process which is fractured posteriorly.

Small left apical pneumothorax.

Conclusion

  • Minimally displaced type III fracture of the odontoid process of C2.
  • Suggestion of an subtle right posterior C1 lateral mass fracture with widening of the right atlanto-occipital joint. MRI is recommended.
  • Fractured left C7 transverse process fused to a cervical rib.
  • Small left apical pneumothorax.

Case Discussion

Peg fractures should be graded I, II or III as the grading indicates the risk of non union and hence the need for operative management.

Always look for upper rib fractures and apical PTX on a C-spine trauma CT.

PlayAdd to Share

Case information

rID: 37474
Case created: 10th Jun 2015
Last edited: 30th Mar 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.