Question
| A. |
Jefferson Fracture |
| B. |
Hangman’s fracture |
| C. |
Cervical Burst Fracture |
| D. |
Cervical Facet Dislocation |
|
Correct Answer � B Explanation |
 |
Ans:B.)Hangman’s fracture.
Image shows:X-ray of the cervical spine with a Hangman’s fracture. Left without, right with annotation. C2 (outlined in red) is moved forward with respect to C3 (outlined in blue).
HANGMAN’S FRACTURE
Hangman fracture, also known as traumatic spondylolisthesis of the axis, is a fracture which involves the pars interarticularis of C2 on both sides, and is a result of hyperextension and distraction.
Clinical presentation
Post-traumatic neck pain after a high-velocity hyperextension injury is the most common presentation. Neurological impairment is seen only in 25% of patients.
Pathology
This is known as a ‘judicial lesion’ as these are the forces delivered by a noose, which, contrary to most ill-informed depictions, was placed with the knot towards the side of the neck, next to the angle of the mandible/mastoid process.
This fracture is virtually never seen in suicidal hanging.
Indeed, it was not even seen in many of those who were judicially hanged; asphyxiation being the usual mode of death.
Major trauma in hyperextension, such as a high-speed motor vehicle accident, is, in fact, the most common association – especially in fatal cases.
Classification:
Levine and Edwards classification
Radiographic features :
bilateral lamina and pedicle fracture at C2
usually associated with anterolisthesis of C2 on C3
Treatment :
Treatment can be bracing or, more typically, internal fixation.
