General considerations

Type A1 fractures involve one single endplate and are in general treated nonoperatively.
Pay attention to the posterior ligaments to avoid misdiagnosing a type B2 fractures as an A1 fracture.
Nonoperative (collars) | ||
Main indication | Skill | Equipment |
---|---|---|
Small wedge fracture; unconscious patient | ![]() |
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Indications:
- Small wedge fractures
- Unconscious patients
Contraindications:
- Burns or other skin lesions
Nonoperative (halo vest) | ||
Main indication | Skill | Equipment |
---|---|---|
Only indicated in selected cases | ![]() |
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The use of a halo vest should be avoided for simple A1 fractures. It is only indicated in rare cases.
Indications
- Need of stabilization but anterior fixation is not possible
Contraindications
- Obese patients
- Spinal cord injury
- Polytrauma
- Fractures or soft tissue injuries of the skull
- Serious osteoporosis
Disadvantages
- Patient compliance needed
- Greatly uncomfortable
- Frequent follow up
- Difficult to maintain personal hygiene
Anterior plating | ||
Main indication | Skill | Equipment |
---|---|---|
Severe wedging; polytrauma; SCI | ![]() |
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Indication:
- Severe wedging
- Polytrauma
- Spinal cord injury
Contraindications
- General surgical contraindications
*Skill | |
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Basic surgical experience, no specialized skills |
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Some specialized surgical experience |
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Highly experienced and skilled surgeon |
*Equipment | |
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Basic equipment only |
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Simple surgical and imaging resources |
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Full specialized surgical and imaging resources |