Pediatric emergency medicine trisk 3608 3608

FIGURE 112.25 A: Diagrammatic representation of transverse ligament disruption (left ) and dens fracture (right ) The arrows indicate the direction of movement that resulted in the noted injury B: Widened predental space on initial lateral radiograph in a 15-year-old girl (actual measurement was mm) C: Flexion radiograph in the same patient demonstrating increased predental space with evidence of transverse ligament disruption D: Dens fracture with anterior subluxation of C1 and the dens on the remainder of the spinal column Arrow indicates fracture