Hangman fracture

Mechanism and manifestations

Also called traumatic spondylolisthesis of the axis, it can occur with hyperextension mechanisms. Symptoms and neurological risk vary; limited canal narrowing does not guarantee mechanical stability.

Diagnosis and management

CT, neurological examination and sometimes MRI assess the injuries. Specialist treatment may be bracing or surgery depending on C2–C3 stability. The historical name does not necessarily describe how the injury occurred.

Points to consider

After trauma, pain intensity and injury severity are not always proportional. Mechanism, level, neurological status and stability guide care. New weakness, sensory loss, breathing difficulty or impaired walking requires urgent assessment.

Role of TAGMED care

With acute symptoms, urgent hospital assessment takes priority. This condition first requires medical diagnosis and, depending on the situation, specialist management. TAGMED services do not replace treatment of infection or tumor, stabilization of an unstable injury, or neurological or vascular treatment. Any conservative support should be considered only after diagnosis, restrictions and the treating team’s recommendations have been clarified.

Related concepts and distinctions

These concepts belong to the same field, but are not synonyms.

• Odontoid fracture — Fracture of the axis dens, classified partly by fracture location and potentially compromising upper cervical stability.
• Cervical teardrop fracture — Cervical fracture with a teardrop-shaped anteroinferior bone fragment, occurring through different mechanisms with variable stability.
• Jefferson fracture — Fracture of the atlas ring, often related to axial loading, with stability depending partly on the transverse ligament.

Medical references

1. AO Foundation. AO Surgery Reference — Occipitocervical trauma.
2. AO Spine. AO Spine classification systems.

References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.