C1 fractureA fracture which occurs with axial loading or axial loading + neck flexion, extension, lateral bending or axial rotation.
C1F victims either die at the scene or present without neurologic deficit—e.g., neck stiffness, limited neck movement, suboccipital pain, muscle spasm, headache.
Open-mouth odontoid views may show displacement of the lateral masses and are more useful than lateral views. Up to 25% of C1 fractures are missed on plain radiographs; a CT provides detailed visualisation of fracture(s).
C1Fs are most common in the 2nd decade of life with a 2:1 male:female ratio, account for 4–15% of all cervical fractures and linked to MVAs/RTAs and falls; 40% are associated with C2 injuries.
Types of C1Fs
Posterior arch fracture, Jefferson fracture.