Les fractures de l'Atlas

Abstract

The authors present details of 22 fractures of the atlas treated at the Orthopaedic Clinic of the University of Athens between 1970 and 1982. After a brief survey of the basis of classification of the four types of fracture, the mechanism of injury, the clinical and radiological presentation and the treatment of these injuries, the authors analyse their own cases and examine their results. Such fractures may go unrecognised because of more obvious associated injuries at other levels in the cervical spine. Neurological signs are uncommon. Treatment has always been orthopaedic and the results are usually excellent.

Management of Acute Traumatic Atlas Fractures

“…The most common causes of atlas fractures are motor vehicle accidents and falls. 1,4,6,13 Rarely are these injuries the cause of a neurologic deficit. 1,2 In our current study, we found the same data.…”

“…Atlas fractures may be associated with other cervical fractures and ligamentous traumatic injuries. 1,3,5,6 We determined that most commonly odontoid fractures of the axis accompany atlas fractures. This compares well with data reported in the literature.…”

“…1,4 The atlas fractures can be divided into several groups. 1,3,5,6 In our study, fractures of the atlas were classified according to the Landells and Van Peteghem guidelines. 5 Three general types of atlas fractures are described by this classification: Type I involves bilateral single arch (anterior or posterior, but not both) fractures.…”

“…[1][2][3][4] Atlas fractures have been classified as a posterior arch, comminuted, bursting (or Jefferson), anterior arch, and transverse process fractures and may be associated with other cervical fractures and ligamentous traumatic injuries. 1,3,5,6 There is insufficient evidence to support treatment standards of these cervical spine injuries. [1][2][3] The goal of the study was to investigate treatment features of acute atlas fractures and to devise an algorithm for treatment of atlas fractures with or without associated axis injuries.…”

Gibt es Therapiealgorithmen bei isolierten und kombinierten Atlas-Frakturen?

“…Halswirbels werden in der Literatur in größeren Serien mit einer Häufigkeit von 2-13 % aller HWS-und 1,3 % aller Wirbelsäulenverletzungen angegeben [1]. Verletzungsmechanismen sind vorrangig indirekte Gewalteinwirkungen wie zumeist Verkehrsunfälle und Stürze [1][2][3][4][5]. In 30-50 % treten sie in Kombination mit anderen Verletzungen der oberen oder unteren HWS auf [2,6], wobei am häufigsten die gleichzeitige Beteiligung des Axis zu nennen ist [2,7,8].…”