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Book

Hangman's Fractures

Devon LeFever  1 , Stephen G. Whipple  2 , Sunil Munakomi  3 , Richard P. Menger  4
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
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Book

Hangman's Fractures

Devon LeFever et al.
Free Books & Documents

Excerpt

Hangman’s fracture is the spondylolisthesis at the C2-3 level following bilateral fractures of the pars interarticularis of the axis. Traumatic spondylolisthesis of the axis, though first described in 1866, the term “Hangman's fracture” was coined in 1965. It is the second most common fracture type involving C2 vertebrae after odontoid fractures and represents approximately 4-20% of all cervical fractures.Steele’s rule of thirds states that the cross-sectional area at the atlas level may be divided into three equally represented parts: the dens, space, and the spinal cord. This increased area for the spinal cord at this level allows for the relative lack of neurologic injury associated with a hangman’s fracture.

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Conflict of interest statement

Disclosure: Devon LeFever declares no relevant financial relationships with ineligible companies.

Disclosure: Stephen Whipple declares no relevant financial relationships with ineligible companies.

Disclosure: Sunil Munakomi declares no relevant financial relationships with ineligible companies.

Disclosure: Richard Menger declares no relevant financial relationships with ineligible companies.

References

    1. Mudumba VS, Pavan S, Alugolu R. Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique. J Craniovertebr Junction Spine. 2022 Jan-Mar;13(1):80-84. - PMC - PubMed
    1. Cai Y, Khanpara S, Timaran D, Spence S, McCarty J, Aein A, Nunez L, Arevalo O, Riascos R. Traumatic spondylolisthesis of axis: clinical and imaging experience at a level one trauma center. Emerg Radiol. 2022 Aug;29(4):715-722. - PubMed
    1. Menon VK. Mechanically Relevant Anatomy of the Axis Vertebra and Its Relation to Hangman's Fracture: An Illustrated Essay. Neurospine. 2019 Jun;16(2):223-230. - PMC - PubMed
    1. Turtle J, Kantor A, Spina NT, France JC, Lawrence BD. Hangman's Fracture. Clin Spine Surg. 2020 Nov;33(9):345-354. - PubMed
    1. Spence KF, Decker S, Sell KW. Bursting atlantal fracture associated with rupture of the transverse ligament. J Bone Joint Surg Am. 1970 Apr;52(3):543-9. - PubMed

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