A Jefferson fracture of C1 often results from some form of vertical compression and results in a 2 or more part fracture of the ring. It is important to look for signs of transverse ligament injury (widening of the atlantoaxial interval, bone avulsion at attachment site, ligament tear on MRI) which indicates unstable injury. It can be associated with fractures of the axis or noncontiguous cervical vertebra.

Case co-author: Rehana Jaffer MD, FRCPC