Hangman's_Fractures

Question 1

Hangman’s Fractures
Cause
Mechanism
% associated injuries

Answer 1

Bilateral fracture pars interarticularis C2

MVA

Hyperextension

39%

Question 2

Levine and Edwards Classification

Answer 2

Type I <3mm horizontal displacement-no angulation
Axial compression and hyper extension
Stable-rigid collar 4-6 weeks
Type II >3mm horizontal displacement-significant angulation-vertical fxr line
C2-3 disc and PLL disrupted
Hyperextension and axial load followed by rebound flexion
Unstable
<5mm displacement-reduction traction & halo 6-12 weeks
>5mm - surgery or prolonged traction
Usually heal despite displacement - autofuse C2-3
Type IIA no horizontal displacement-horizontal fxr line-significant angulation
Flexion-distraction
AVOID TRACTION-reduction gentle axial load + hyperextension then
compression halo 6-12 weeks
Type III - Type I pattern with bilateral C2-3 facet dislocation - rare
Flexion-distraction followed by hyperextension
Surgical reduction of facet dislocation followed by stabilization