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Cervical Spine Fractures

MECHANISMS

  • Hyperflexion
  • Hyperflexion and rotation
  • Hyperextension
  • Hyperextension and rotation
  • Vertical compression and burst injury
  • Lateral flexion
  • Direct shearing
  • Penetrating
  • Other

JEFFERSON FRACTURE

  • burst # of atlas (C1)
  • combined anterior and posterior arch fractures
  • from axial compression of C1
  • can result from hyperextension causing a posterior arch #
  • typical history: diving head first into water, thrown against roof of car
  • unstable

HANGMAN FRACTURE

  • bilateral fracture of the posterior arch of C2 and disruption of the C2-3 junction
  • neurological injury may result from damage to the posterior longitudinal ligament allowing significant anterior displacement of C2 on C3
  • from hyperextension with vertical compression of the posterior column
  • typical history: car accident with patient striking head on dashboard
  • unstable

CLAY SHOVELLER FRACTURE

  • fracture of one or more of the spinous processes of the C6-T3 vertebra
  • avulsion fracture by the supraspinous ligament of the spinous process caused hyperflexion
  • stable

CCC Neurocritical Care Series

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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