Hangman fracture

Case contributed by Talal F M Abdullah
Diagnosis certain


Road traffic accident, neck pain, no neurological deficit.

Patient Data

Age: 25 years
Gender: Female

Bilateral pars fractures of C2 seen on the lateral projections. 


Bilateral traumatic spondylolysis (pars fracture) of C2 in keeping with a Hangman's fracture.

On the right, the fracture extends to the right pedicle and right foramen transversarium.

Although a profound injury, yet no anterior dislocation but rather a subtle anterior subluxation of C2/3.


Fracture line seen again.

No evidence of cord contusion or edema.

Case Discussion

Traumatic pars fractures (spondylolysis) of C2 extending into right foramen transversarium in keeping with a Hangman's fracture (Levine and Edwards type II).  Unfortunately, this was not followed by a contrast study to assess the right vertebral artery.  However, the patient was neurologically free and stable as she walked through to do plain film.  Subsequent MRI shows no cord contusion/edema.

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