Question

Case Scenario:
A young man met with an accident and brought to A/E by ambulance. The clinician strongly
suspects hangman’s fracture.
You are expected to elaborate the followings:
• Hangman’s fracture.
• Basic projections with patient position, part position, central ray and collimation.
• Additional projections if any
• Appropriate images (insert images with labeling).
• Further imaging modalities (if any) which can be used to evaluate the fracture.
• Discussions
• Medical literature to support to support your case report.

Answer 1

Hangman's fracture is the name given to a fracture of both pedicles, or pars interarticulares, of the axis vertebra (C2).

Cause- injury mainly occurs from falls, usually in elderly adults, and motor accidents mainly due to impacts of high force causing extension of the neck and great axial load onto the C2 vertebra.

The mechanism of the injury is forcible hyperextension of the head, usually with distraction of the neck. Traditionally this would occur during judicial hanging, when the noose was placed below the condemned subject's chin. When the subject was dropped, the head would be forced into hyperextension by the full weight of the body, a sufficient force to cause the fracture

Surgical treatment-operative treatment such as using transoral C2-C3 discectomy with plate-cage stabilization or posterior direct pars screw repair for the reducing and healing process.