Spine: Jefferson fracture: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: Jefferson fracture

Sample item

A man who dived into shallow water has neck pain, and an open-mouth view shows lateral displacement of both lateral masses of C1. What is the injury?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Jefferson (burst) fracture of the atlas

Jefferson fracture is a burst fracture of the ring of C1 from axial loading, usually with fractures at both anterior and posterior arches. Spreading of the lateral masses over 7 mm indicates transverse ligament rupture and instability.

Option by option

  • A. Jefferson (burst) fracture of the atlas (correct)

    Correct. Axial load with C1 lateral mass spread is a Jefferson fracture.

  • B. Clay-shoveler fracture

    Clay-shoveler fracture is a spinous process avulsion of C6 or C7.

  • C. Hangman fracture of C2

    Hangman fracture involves the pars of C2 from hyperextension.

  • D. Odontoid fracture

    An odontoid fracture involves the dens of C2.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Jefferson (burst) fracture of the atlas. Jefferson fracture is a burst fracture of the ring of C1 from axial loading, usually with fractures at both anterior and posterior arches.

Why is "Clay-shoveler fracture" not the answer?

Clay-shoveler fracture is a spinous process avulsion of C6 or C7.

Why is "Hangman fracture of C2" not the answer?

Hangman fracture involves the pars of C2 from hyperextension.

Why is "Odontoid fracture" not the answer?

An odontoid fracture involves the dens of C2.

What concept does this question test?

It tests Spine: Jefferson fracture in Orthopaedics. Spreading of the lateral masses over 7 mm indicates transverse ligament rupture and instability.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: Jefferson fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.