Background
- Bilateral pars fracture
Classification
- Type 1
- Axial and hyperextension
- <3mm displacement stable
- Management
- Collar
- Type 1A
- pars on one side body on the other (more unstable)
- Management
- Halo
- Type 2
- Type 1 then rebound flexion
- >3mm
- Management
- Halo
- C23 ACDF
- C1-3 PSIF
- Type 2A
- Flexion distraction
- Angulated
- Management
- Reduction with Halo
- C23 ACDF
- C1-2 PSIF
- Type 3
- Hangman plus facet dislocation
- MRI r/o disc
- Management
- C1-3 PSIF
- C23 ACDF +/- C1-3 PSIF
C Spine Instability
- White’s Rule
- 3.5mm translationn
- 10degrees kyphosis
Hangman fracture, what is true? (repeat)
Usually flexion mechanism)
usually do well (high rate of union) with non op treatment
Associated with neurocompromise
related to C3-4 ligament sprain