Simultaneous complex cervical fractures in an older adult: a case report of Jefferson, Hangman, and type III odontoid fractures
DOI:
https://doi.org/10.59156/xxh9nt26Keywords:
Cervical Atlas, Cervical Spine, Hangman’s Fracture, Traffic AccidentsAbstract
Background: multiple cervical fractures represent a significant diagnostic and therapeutic challenge, particularly in older adults, in whom bone fragility and comorbidities may increase the risk of complications. The coexistence of Jefferson, Hangman, and Type III odontoid fractures is exceptionally rare, and its management requires careful assessment of cervical stability and the patient’s functional status.
Objectives: to describe a case of complex cervical fractures in a geriatric patient following a motor vehicle accident and to discuss relevant aspects of imaging diagnosis, therapeutic decision-making, and the surgical approach employed.
Case description: an 82-year-old woman with no significant past medical history was involved in a motor vehicle accident as a passenger. On admission, she was alert and neurologically intact. Computed tomography (CT) of the cervical spine revealed a fracture of the posterior arch of C1 consistent with a Jefferson fracture, bilateral fractures of the C2 pedicles consistent with a Hangman fracture, and a Type III odontoid fracture according to the Anderson and D’Alonzo classification. Given the instability of this fracture pattern and the risk of secondary displacement, surgical treatment was indicated.
Surgery: an anterior C1-C2 cervical stabilization procedure with open reduction and placement of fenestrated screws was performed. The procedure was completed without intraoperative complications. The patient experienced a favorable neurological recovery, and postoperative CT confirmed satisfactory reduction and fixation of the fractures.
Conclusion: this case demonstrates that, even in elderly patients, a comprehensive evaluation and a timely, well-planned surgical strategy can achieve satisfactory outcomes in complex cervical injuries. Reporting such cases contributes to expanding the available evidence and may help guide the management of cervical trauma in the geriatric population.
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