Jefferson fracture in a child--illustrative case report

In adults, atlas burst fractures (Jefferson fractures) are not uncommon. In the pediatric population, they are extremely rare, and only few cases have been reported so far. They all showed a highly consistent clinical presentation with rare neurological deficits as well as recovery with full function without any surgical intervention. We describe a case of a Jefferson fracture in a 7.5-year-old-boy after falling onto the top of his head, presenting solely with slight neck pain. The initial radiological characteristics are presented on magnetic resonance imaging (MRI) and computer tomography (CT); the bony bridging and fusion of the fracture sites are demonstrated on CT during the course of the healing. The patient was placed in a rigid cervical collar, and his physical examination results remained normal according to age. Complete fusion of both fracture sites was seen on the third follow-up 6.5 months after presentation. In this rare case of a Jefferson fracture in a child monitored by radiological imaging techniques, important aspects of conservatively treated atlas burst fractures are illustrated. It underlines their benign character and favorable outcome with full functional recovery without any surgical intervention.