Hangmanfraktur

Hangmanfraktur, also known as a traumatic spondylolisthesis of the axis or a fracture of the C2 vertebra, refers to a fracture of the pars interarticularis of the axis vertebra (C2). This specific type of fracture is often associated with hyperextension and distraction of the neck, a mechanism commonly seen in judicial hangings, hence the name. However, it can also occur in other high-energy trauma incidents such as motor vehicle accidents or falls.

The fracture typically involves a break through the posterior elements of the C2 vertebra, specifically the isthmus connecting the superior and inferior articular facets. This can lead to instability of the cervical spine, as the integrity of the C2 vertebra is compromised. Symptoms can range from neck pain and stiffness to neurological deficits if there is associated spinal cord compression.

Diagnosis is usually made through radiographic imaging, including X-rays, CT scans, and MRI of the cervical spine. Treatment depends on the degree of instability and displacement. Non-operative management, such as a cervical collar, may be sufficient for stable fractures. However, unstable fractures often require surgical intervention to achieve spinal fusion and stabilization to prevent further neurological damage. The prognosis varies based on the severity of the injury and the presence of neurological compromise.