A Hangman's Fracture, often colloquially referred to as "Hangman's Neck," is a specific and serious type of injury affecting the cervical spine, particularly the second cervical vertebra (C2). It is a fracture pattern that involves a bilateral break in the pars interarticularis of C2, accompanied by a forward displacement (subluxation) of C2 relative to the third cervical vertebra (C3).
Understanding the Injury
This fracture is characterized by a precise set of features:
- Location: It occurs in the axis, which is the second bone in the neck (C2). The C2 vertebra is crucial for neck rotation and stability.
- Fracture Type: The injury involves a bilateral fracture (meaning it breaks on both sides) that traverses the pars interarticularis. The pars interarticularis is a small segment of bone connecting the superior and inferior articular processes of a vertebra.
- Associated Displacement: Crucially, a Hangman's Fracture also includes an associated traumatic subluxation of C2 on C3. Subluxation means a partial dislocation, where the two vertebrae are no longer perfectly aligned. This traumatic displacement adds to the instability of the spinal column.
Clinical Significance and Prevalence
The Hangman's Fracture is a significant injury in the context of C2 fractures:
- It is recognized as the second most common fracture of the C2 vertebrae.
- Its prevalence is only surpassed by fractures of the odontoid process, which is a tooth-like projection extending upwards from the body of the C2 vertebra.
The term "hangman's" originates from the historical association with judicial hanging, where the rapid, forceful extension and distraction of the neck could lead to this specific type of spinal injury. However, in modern trauma, these fractures are more commonly seen in high-impact events such as motor vehicle accidents, particularly those involving hyperextension and axial loading.
Key Characteristics at a Glance
For a clearer overview, here are the defining characteristics of a Hangman's Fracture:
| Characteristic | Description |
|---|---|
| Vertebra Involved | Cervical Vertebra 2 (C2), also known as the Axis |
| Fracture Type | Bilateral fracture traversing the pars interarticularis |
| Associated Injury | Traumatic subluxation of C2 on Cervical Vertebra 3 (C3) |
| Prevalence Ranking | Second most common C2 fracture |
| Preceded By | Fractures of the odontoid process (as the most common C2 fracture) |
