Cervical Fractures
Stenberg College
Nursing students
2014
What is a cervical fracture?
 A cervical fracture is a break
in one or more of the seven
cervical vertebrae in a
patient’s neck.
 Cervical vertebrae supports
one’s head, allowing the
neck to bend and twist.
 The Vertebrae is a
protective wall that protects
the spinal cord.
Causes of a cervical fracture
 The majority of cervical fractures are caused by
sudden, forceful impact.
 Other most commons include:
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Motor vehicle accidents
Falls
Dives into shallow water
Injuries from contact sports
Skateboarding injuries
Signs and Symptoms
 Pain, tenderness, swelling, or muscle cramps in the
neck
 Trouble swallowing
 Problems moving your neck
 Numbness, pain, or tingling at the base of your head
 Loss of feeling or pinprick in the legs or arms
 Double vision or loss of consciousness
Common types of cervical fractures
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Odontoid fracture
Hangman’s fracture
Jefferson fracture
Teardrop fracture
 Diagnosing: CT scan, MRI, and x-ray which are
typically done in the emergency department.
Odontoid fracture
 The odontoid is a part of
your C2 vertebrae, also
known as the axis.
 When the odontoid
breaks, one can not twist
and turn their neck freely.
 This type of fracture is
quite common in children
Hangman’s fracture
 Another type of fracture
involving a break in the
axis.
 Results from
hyperextension and
distraction
Jefferson fracture
 Consists of three or four
breaks in the C1
vertebrae, AKA the atlas.
 Bones in the axis may also
be broken
Teardrop fracture
 This type of fractures are
large, triangle-shaped
breaks in one or more of
the lower cervical
vertebrae.
 They can also affect
nearby ligaments and
discs.
Educating nurses
Preoperative assessment for positioning needs should
be made before transferring the patient to the bed.
This is especially important when the patient has a
cervical spine injury to prevent further damage to the
cord.
Maintenance of spinal immobilization throughout the
transfer process is essential while keeping in mind that
a cervical collar alone doesn’t completely immobilize
the spine.
Educating nurses cont.
 Prepare the bed as for the cervical halter traction.
Use an alternating pressure mattress, if one is
available, when the patient is in a conventional bed.
 The patient in tong traction may be immobilized for a
long period of time, so he may be placed on a Foster
frame.
Educating nurses cont.
 Do not move the tongs that have been inserted in the
parietal area of the skull and the tong is then
attached to the pulling device.
 Use the “log roll” for in turning, bed making and back
care.
 Feed the patient slowly and with great care. Allow
plenty of time to chew and swallow. Keep suction
equipment at the bedside for emergency use.
Preoperative Assessments
 Preoperative assessment should include assess the
patient for condition that will effect proper
positioning or lead to intraoperative complications
such as: extremes of age, degenerative changes or
poor skin integrity.
Moving and positioning
 Moving the patient should be a coordinated
approach, with a person preferably the team leader
coordinating all moves.
 Manual immobilization is much more effective than
any external immobilization.
 Using a team of four or more and logrolling the
patient will make a transfer smooth and be effective
in reducing the risk of pressure ulcers.
 Use of sled
Types of traction
 Halo traction- typically
used to stabilize cervical
spine fractures.
 Once proper alignment
has been established, a
halo vest is often applied
to provide ongoing
immobilization of the
cervical.
Nursing Alert!
 The nurse must never
remove weights from
skeletal tractions unless a
life-threatening situation
occurs or Doctors orders.
Removal of the weights
completely defeats their
purpose and may result in
injury, infection, severe pain,
nerve and mussel damage,
and further spinal injury to
the patient.
Nurses responsibility
Maintain integrity of the halo external fixation device.
 a. Inspect pins and traction bars for tightness; report loosened pins to
physician.
 b. Tape the appropriate wrench to the head of the bed for

emergency intervention.
 c. Never use the halo ring to lift or reposition the client.
 Loosening of the apparatus poses the risk of further damage to the
cord. It is the responsibility of the nurse to maintain the integrity of the
apparatus and the safety of the client.
Responsibilities cont…
Assess muscle function and skin sensation every 2 hours in the acute
phase and every 4 hours thereafter.
 a. Assess motor function on a scale of 0 to 5, with 0 being no
evidence of muscle contraction and 5 being normal muscle
strength with full range of motion.
 b. Assess sensation by comparing touch and pain, moving from
impaired to normal areas, and testing both the right and left sides of
the body.
Monitoring muscle function and skin sensation allows early identification
of potential neurologic deficits.
Nurses responsibilities cont..
Monitor pin sites each shift and follow hospital policy for pin
care. Here are some general guidelines.
 a. Assess pin sites for redness, edema, and drainage.
 b. Depending on policy, clean each pin site with a sterile applicator
dipped in hydrogen peroxide, apply a topical antibiotic, and cover
with sterile 2-inch split gauze squares.
Organisms can enter the body through the pin-insertion site; assessments
and care are provided to detect signs of and prevent infection
Responsibilities cont…
Maintain skin integrity.
a. Turn the immobile client every 2 hours.
b. Inspect the skin around edges of the vest every 4 hours.
c. Change the sheepskin liner when it is soiled and at least
once each week.
These interventions prevent skin injury and irritation.
Skin Breakdown and Pressure Sores
 Insufficient padding, inappropriate vest size, or poor
application can result in skin breakdown and resultant
pressure sores.
 Pressure sores usually develop underneath the vest
because of the pressure against a bony prominence.
 The scapula and along one’s spine are common places for
skin breakdown.
 This can be prevented by adequate padding turning and
repositioning.
 Daily care of the vests should include meticulous skincare
and assessment to assess for early signs of skin irritation.
References
 http://wps.prenhall.com/wps/media/objects/737/75539
5/halo_fixation.pdf\
 http://armymedical.tpub.com/md0916/md09160039.h
tm
 http://www.nursingcenter.com/lnc/cearticle?tid=1037
060#sthash.Qp09tbfj.dpuf
 http://home.portervillecollege.edu/eKeele/Skeletal%2
0Muscle/MS%202.pptx