Jefferson fracture
(jĕf'ĕr-sŏn 
)
[Geoffrey Jefferson, British neurologist and neurosurgeon, 1886–1961]
A burst fracture of the first cervical vertebra (atlas), usually involving the anterior and posterior arches, that results from compression of the cervical spine. Jefferson fractures are classified as stable when the transverse ligament is intact and unstable when the ligament has been ruptured. The majority of Jefferson fractures are associated with other spinal pathology, esp. fractures of the second cervical vertebra (axis).
SEE: halo vest.
Symptoms: The patient may complain of pain arising from the upper cervical spine but may not demonstrate signs or symptoms of neurological impairment. On x-ray examination, odontoid views may demonstrate displacement of the C1-C2 facets. Lateral and flexion-extension views are needed to ascertain the status of the transverse ligament.
Treatment: For unstable fracture, cranial traction, skeletal traction, and /or halo vest are applied for a total of 3 months. A nondisplaced stable fracture may be treated with the use of a soft cervical collar. Stable fractures with less than 7 mm displacement require the use of a rigid cervical collar. Follow-up evaluations should be performed regularly, to rule out insidious subluxation of the first cervical vertebra.