Is this fracture stable?
No. It is an unstable fracture associated with possible complete disruption of ligaments.
Unstable flexion teardrop fracture of C2 is noted involving the anterior inferior body and both pedicles extending through the foramen transversarium bilaterally. This pushes the C2 vertebral body and consequently the atlas anteriorly. Nondisplaced fracture of the anterior arch of C1 is noted. There is no significant anterior displacement of C2 on C3 noted. There is a posterosuperior corner injury of the C3 vertebral body and this extends towards but not into the left C3 pedicle. Throughout the remainder of the C-spine, no further fracture is identified. There is prevertebral soft tissue swelling noted.
No facial bone or intracranial injury (images not shown).
The left vertebral artery is congenitally hypoplastic and arises directly from the arch, terminating in PICA. The right vertebral artery is a large calibre vessel. There is no vertebral artery stenosis or dissection identified. The basilar artery and posterior cerebral arteries appear unremarkable. The common and internal carotid arteries appear unremarkable. The anterior and middle cerebral arteries are patent as are the branch vessels. No aneurysm, AV malformation or dural fistula is identified. The soft tissues of the neck demonstrate anterior stranding.