Presentation
Road traffic accident whilst under the influence of alcohol. Neurologically stable.
Patient Data
Bilateral pars interarticularis fractures of C2 vertebra. The right parsinterarticularis fracture is slightly displaced.
C2-C3 disc height is mildly increased with subtle anterolisthesis of C2.
No significant paraspinal haematoma or spinal cord compression.
The atlantodental and atlantoaxial spaces are normal.
Bilateral pars interarticularis fractures.
Focal disruption of anterior longitudinal ligament at C2/3 level.
The posterior longitudinal ligament is intact. No significant anterolisthesis.
Bone marrow oedema involving the superior endplates of C3 and T2 vertebral bodies.
The spinal cord is of normal calibre and signal. No evidence of cord oedema or contusion.
Case Discussion
Hangman fracture is a fracture which involves both pars interarticularis of the C2 vertebra. It is typically the result of a hyperextension and distraction injury.
The name originates from the injury sustained during judicial hanging. In this case a high speed RTA was the responsible mechanism responsible for the hyperextension injury of this patient's cervical spine.
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