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Hangman's fracture
From WikEM
Contents
Background
- Also known as traumatic spondylolisthesis
- Is an unstable spine injury
- Bilateral C2 pedicle fracture (leads to C2 displacing anteriorly on C3)
Clinical Features
- Seen in MVA, diving accidents, but uncommonly judicial hangings (not in suicidal hangings)[1]
- Forced extension of an already extended neck
- Spinal cord damage is often minimal (diameter of neural canal is greatest at C2)
Differential Diagnosis
Cervical Spine Fractures and Dislocations
- Atlanto-occipital dissociation
- C1
- C2
- Odontoid fracture
- Hangman's fracture
- C3-C7
- Cervical facet dislocation
Evaluation
- Xray or CT cervical
Management
Prehospital Immobilization
See NAEMSP National Guidelines for Spinal Immobilization
Hospital
- C-collar
- Consult ortho or spine as needed
Disposition
- Admit
See Also
References
- ↑ James, R. and Nasmyth-Jones, R. (1992) ‘The occurrence of cervical fractures in victims of judicial hanging’, Forensic Science International, 54(1), pp. 81–91