ArticleGlobal spine journal2018
Treatment of Atlas Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).
Article in Global spine journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- C1-ring osteosynthesis for Jefferson fracture: a multi-institutional retrospective case series.Journal of trauma and injury · 2026Article
- Posterior Fixation Combined with Anterior Transoral Plate Osteosynthesis for Chronic Gehweiler IIIb Atlas Fracture-Dislocation: Case Report and Literature Review.Journal of clinical medicine · 2026Article
- Initial fracture gap distance as a potential quantitative predictor for atlas fracture nonunion: A preliminary retrospective analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- A Case Report of an Unstable C-spine Fracture in the Emergency Department.Journal of education & teaching in emergency medicine · 2025Article
- [Conservative treatment of injuries to the cervical spine : Mobilization or immobilization].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- The surgical treatment of upper cervical spine trauma in octogenerians.Brain & spine · 2025Article
- The use of a novel reduction plate in transoral anterior C1-ring osteosynthesis for unstable atlas fractures.Frontiers in surgery · 2023Article
- Interobserver reliability of the Gehweiler classification and treatment strategies of isolated atlas fractures: an internet-based multicenter survey among spine surgeons.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Anterior reduction and C1-ring osteosynthesis with Jefferson-fracture reduction plate (JeRP) via transoral approach for unstable atlas fractures.BMC musculoskeletal disorders · 2021Article
- Spine trauma: Radiological approach and new concepts.Skeletal radiology · 2021Review
- Jefferson Fracture and the Classification System for Atlas Fractures, A Case Report.Journal of education & teaching in emergency medicine · 2021Article
- Pharyngeal perforation: A rare complication of occipitocervical injury.Surgical neurology international · 2021Article
- Upper Cervical Spine Trauma: WFNS Spine Committee Recommendations.Neurospine · 2020Article
- Epidemiology and management of atlas fractures.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Article
- Motion-Preserving Navigated Primary Internal Fixation of Unstable C1 Fractures.Asian spine journal · 2020Article
- Traumatic Atlantoaxial and Fracture-Related Dislocation.BioMed research international · 2019Article
- Perioperative complications associated with fluoroscopy C1 lateral mass screw fixation (Goel technique) versus computed tomography-guided navigation technique: A review of 202 cases from the German Spine Registry (DWG-Register).Journal of craniovertebral junction & spineArticle
- Atlas fractures with and without simultaneous dens fractures differ with respect to clinical, demographic, and management characteristics.Journal of craniovertebral junction & spineArticle
- Diagnosis and management of isolated C1 fractures: A systematic review.Journal of craniovertebral junction & spineReview
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designNarrative review and expert recommendation.
objectivesTo establish treatment recommendations for atlas fractures based on the knowledge of the experts of the Spine Section of the German Society for Orthopaedics and Trauma.
methodsNeither high-level evidence studies comparing conservative and operative management nor studies matching different operative treatment strategies exist. This recommendation summarizes the knowledge of the experts of the Spine Section of the German Society for Orthopaedics and Trauma with regard to the treatment of atlas fractures.
resultsMost atlas fractures are the result of compression forces. A valuable morphological classification system has been described by Gehweiler. For an adequate diagnosis, a computed tomography is mandatory. To distinguish between stable and unstable type 3 injuries, it is necessary to evaluate the integrity of the transverse atlantal ligament (TAL) with magnetic resonance imaging and to classify the TAL lesions. The majority of atlas fractures are stable and will be successfully managed conservatively. Unstable atlas fractures (type 3b and sagittal split type 4 fractures) should be treated by surgical stabilization. Unstable atlas fractures (type 3b) with a midsubstance ligamentous disruption or severely dislocated ligamentous bony avulsions of the TAL can successfully be treated by a C1/2 fusion. Unstable atlas fractures (type 3b) with a moderately dislocated ligamentous bony avulsion of the TAL and sagittal split type 4 fractures may be treated by atlas osteosynthesis only.
conclusionsWhereas the majority of atlas fractures can be managed conservatively, in specific fracture patterns surgical treatment strategies have become the standard of care.
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