125: JEFFERSON FRACTURE

ICD-9-CM CODES

• 738.4 Acquired spondylolisthesis

• 756.12 Spondylolisthesis congenital

• 805.01 Closed fracture of first cervical vertebra

ICD-10-CM CODES

• M43.10 Spondylolisthesis, site unspecified

• Q76.2 Congenital spondylolisthesis

• S12.000A Unspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture

• S12.001A Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture

PREFERRED PRACTICE PATTERN

• 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation¹

KEY FEATURES

Description

• Anterior (forward) translation of a vertebra

• Fracture of the anterior and posterior arches of the C1 vertebra

• Slipping of the vertebra in relationship to the vertebra below

• Ataxia

• Fracture widens at the pars

• Typically a four-part or “burst” fracture

Essentials of Diagnosis

• Diagnosis made by X-ray, children may require CT scan

• Clinical examination may find step deformity

• Axial load on top of the head

• Reports diving into a shallow pool

General Considerations

• Instability

• Avoid extension positions that increase symptoms

Demographics

• Usually from landing on head, as with diving into a shallow pool

CLINICAL FINDINGS

Functional Implications

• Difficulty maintaining standing postures secondary to neck pain

• Difficulty with movements (reaching overhead) secondary to pain

• Limited sports participation

• Can cause quadriplegia or death

Possible Contributing Causes

• Forceful extension from hit under the chin (as in sports)

• Car accident, hit from rear

• Hyperextension of the cervical spine

• Diving into a shallow pool