Avulsion of the transverse ligament associated with a fracture of the atlas: a case report.

Avulsion or rupture of the transverse ligament may occur in combination with a Jefferson fracture of the atlas as a result of the spreading of the lateral masses of C1. In this patient, an avulsion of the transverse ligament was associated with a fracture of the atlas without spreading of the lateral masses and in combination with a wedge compression fracture of the body of C5. It is also important to consider that multiple injuries to the upper cervical spine (occiput to C2) can and do occur with relative frequency. Appropriate management is based not on the principle of stabilizing all injuries with one procedure, but rather techniques that may be used sequentially to achieve stabilization with minimal morbidity.