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Spinal fracture classification

Update your RDS mobile app to v4.7.1 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Spinal fracture classification

Orthotics Spinal Pathways

The information below is contained in papers found in the literature search carried out to inform this clinical decision making tool.

View C1 - C4 Pathway

Odontoid Peg Fracture Classification / D’Alonso & Anderson classification

Type I

rare
fracture of the upper part of the odontoid peg
above the level of the transverse band of the cruciform ligament
usually considered stable

Type II

most common
fracture at the base of the odontoid peg
below the level of the transverse band of the cruciform ligament
unstable
high risk of non-union

Type III

through the odontoid peg and into the lateral masses of C2
relatively stable if not excessively displaced
best prognosis for healing because of the larger surface area of the fracture

Hangman/Pedicle Fracture Classification

Levine and Edwards classification is used to classify Hangman Fractures of C2 (also known as traumatic spondylolisthesis of axis).

Type I

fracture with <3 mm antero-posterior deviation
no angular deviation

Type II

fracture with >3 mm antero-posterior deviation
significant angular deviation
disruption of posterior longitudinal ligament

Type IIa

the fracture line is horizontal/oblique (instead of vertical)
significant angular deviation without anterior translation

Type III

type I with bilateral facet joint dislocation

Guidelines

National Institute of Health and Care Excellence (NICE). Spinal injury guideline: assessment and initial management. NG41. 2016

Last reviewed: 02/04/2024

Next review date: 01/05/2026

Reviewer name(s): Aimie Holland, Susie Hughes, Nikki Munro.