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Lateral view of a cervical spine radiograph of an 18-year-old woman who sustained a motor vehicle accident shows anterolisthesis of C2 over C3 (arrowhead) and fracture lines involving the C2 pars interarticulares. The anterior and posterior spinal lines are disrupted.
Hangman’s Fracture
* Traumatic spondylolisthesis of C2
* Fractures of the lamina, articular facets, pedicles or pars interarticulares of C2 with disruption of C2-C3 junction
* Common etiology: fall, diving, motor vehicle collision
* Treatment options depend on the stability of the fracture. Stable injuries without neurological deficit and signs of later instability – usually require only immobilization for a period of time.
Look for:
* If there is anterior translation of C2 over C3, if translation >3 mm with >10 degree angulation — likely unstable
* If there is dislocation of facet joints — likely unstable
* Other associated C-spine pathology (found in up to 1/3 of cases)
Reference:
Li XF, Dai LY, Lu H, Chen XD. A systematic review of the management of hangman’s fractures. Eur Spine J 2006;15:257-269.
