In a Dens 2 (Burst) fracture, which columns are primarily affected?

In a Dens 2 (Burst) fracture, the primary concern is the integrity of the vertebral columns, especially when dealing with the dens, or odontoid process, of the second cervical vertebra (C2). This type of fracture typically involves the anterior and middle columns.

The anterior column consists of the vertebral body and the adjacent disc space, while the middle column includes the posterior part of the vertebral body and the anterior longitudinal ligament. In a Dens 2 fracture, there is often significant displacement and instability that can compromise these columns, leading to potential neurological involvement due to the proximity of the spinal cord.

Understanding the anatomy and how these columns relate to spinal stability is critical in diagnosing and planning treatment for such injuries. The focus on the anterior and middle columns in these injuries helps guide clinical decision-making regarding necessary interventions, such as surgical stabilization or conservative management. This understanding is essential for effective assessment and treatment in orthotic and prosthetic practice.