Axial loading with hyperflexion injury to the atlas resulting in crushed lateral masses.

A 40-year-old man was involved in an ATV accident, in which he landed on the top of his head. There was no neurological deficit. A plain radiograph showed prevertebral soft tissue swelling at the atlas and axis level. Computed tomography (CT) demonstrated vertical fractures of the anterior aspects of both lateral masses of the atlas, extending to the junction of the lateral mass with the anterior arch bilaterally. There was no lateral offset of the lateral masses. The mechanism of injury is believed to be axial loading along with hyperflexion.

Horizontal fracture of the anterior arch of the atlas associated with a congenital cleft of the anterior arch.

We report a rare combination of a horizontal fracture of the anterior arch of the atlas associated with a congenital cleft of the anterior arch. Sagittally reformatted computed tomography (CT) images demonstrated a fracture of the anterior arch of the atlas and a type II odontoid process fracture. There was also a smoothly marginated midline cleft of the anterior arch just above the fracture consistent with a congenital variant. 3D CT images were helpful in the evaluation of the fractures and the developmental variant. Magnetic resonance imaging showed a spinal cord injury. The patient underwent posterior C1-C2 fusion.

[Lifestyle differences between conjugal bereaved women and non-bereaved women in later life].

PURPOSES: In Japan, there has been limited research regarding lifestyle of elderly bereaved. The present study was conducted to clarify lifestyle characteristics in conjugal bereaved women compared to non-bereaved women. METHODS: Subjects consisted of 872 bereaved and 643 non-bereaved elderly women aged 65 or over in T prefecture. Bereaved subjects experienced the death of a spouse in 1994 and their family structure remained unchanged after the bereavement. Non-bereaved subjects were randomly selected from community registration lists in 1995 and matched for age and area of residence. Lifestyle characteristics were obtained by home visit and interview. For the analysis, we divided the subjects into 4 groups by age and family structure. Multiple logistic regression analysis was performed to identify lifestyle characteristics of bereaved elderly women, after adjustment for physical ability and disease, as confounding factors. RESULTS: Bereaved elderly women were significantly associated with no roles at home, no hobbies, lack of contact with friends, physical inactivity, sleeplessness and irregular meal patterns compared to the non-bereaved. Analysis of the 4 groups revealed bereaved women living with family members have more unfavorable lifestyle characteristics than bereaved women living alone. Bereaved women living with family members had no roll at home and sleeplessness. CONCLUSION: Bereaved women have unfavorable lifestyle characteristics. Those living with family members had more unfavorable lifestyle than bereaved women living alone. From the preventive point of view, interventions for bereaved women are needed. This is particularly the case for bereaved women living with family members. Not only health services but also social welfare services are needed to reconstruct favorable lifestyles and maintain health and well-being.