Case: We describe the clinical presentation, management, and outcomes of 3 patients, aged 1.5 to 4 years, with C1 synchondrosis (“Jefferson”) fractures treated nonoperatively. Minimally widened anterior arch fractures were identified on computed tomography that were not visible on conventional radiographs. Serial imaging showed fracture healing in all patients at minimum 1-year follow-up. Conclusion: These cases highlight the susceptibility of preschool-aged children to “baby Jefferson” fractures through the anterior synchondroses, the importance of early computed tomography imaging when conventional radiographs are inconclusive, and the favorable outcomes of nonoperative treatment with cervical immobilization of stable, nondisplaced pediatric C1 fractures.
Park et al. (2025) studied this question.