Fractures through bilateral C2 pars interarticularis
Avulsion of C2 body from facets, neural arch
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Patel JYK et al: Unstable hangman's fracture: anterior or posterior surgery? J Craniovertebr Junction Spine. 10(4):210-5, 2019
Al-Mahfoudh R et al: Management of typical and atypical hangman's fractures. Global Spine J. 6(3):248-56, 2016
Hadley MN et al: Introduction to the guidelines for the management of acute cervical spine and spinal cord injuries. Neurosurgery. 72 Suppl 2:5-16, 2013
Ryken TC et al: Management of isolated fractures of the axis in adults. Neurosurgery. 72 Suppl 2:132-50, 2013
Pryputniewicz DM et al: Axis fractures. Neurosurgery. 66(3 Suppl):68-82, 2010
Yanni DS et al: Fixation of the axis. Neurosurgery. 66(3 Suppl):147-52, 2010
Congress of Neurological Surgeons: Isolated fractures of the axis in adults. Neurosurgery. 50(3 Suppl):S125-39, 2002
Congress of Neurological Surgeons: Management of combination fractures of the atlas and axis in adults. Neurosurgery. 50(3 Suppl):S140-7, 2002
Ranjith RK et al: Hangman's fracture caused by suspected child abuse. A case report. J Pediatr Orthop B. 11(4):329-32, 2002
Harrop JS et al: Acute respiratory compromise associated with flexed cervical traction after C2 fractures. Spine. 26(4):E50-4, 2001
Samaha C et al: Hangman's fracture: the relationship between asymmetry and instability. J Bone Joint Surg Br. 82(7):1046-52, 2000
Agrillo U et al: Hangman's fracture. Spine. 24(22):2412, 1999
Guiot B et al: Complex atlantoaxial fractures. J Neurosurg. 91(2 Suppl):139-43, 1999
Josten C: [Traumatic spondylolisthesis of the axis.] Orthopade. 28(5):394-400, 1999
Williams JP 3rd et al: CT appearance of congenital defect resembling the Hangman's fracture. Pediatr Radiol. 29(7):549-50, 1999
Greene KA et al: Acute axis fractures. Analysis of management and outcome in 340 consecutive cases. Spine. 22(16):1843-52, 1997
Nunez DB Jr et al: Cervical spine trauma: how much more do we learn by routinely using helical CT? Radiographics. 16(6):1307-18; discussion 1318-21, 1996
Starr JK et al: Atypical hangman's fractures. Spine. 18(14):1954-7, 1993
James R et al: The occurrence of cervical fractures in victims of judicial hanging. Forensic Sci Int. 54(1):81-91, 1992
Parisi M et al: Hangman's fracture or primary spondylolysis: a patient and a brief review. Pediatr Radiol. 21(5):367-8, 1991
Burke JT et al: Acute injuries of the axis vertebra. Skeletal Radiol. 18(5):335-46, 1989
Fielding JW et al: Traumatic spondylolisthesis of the axis. Clin Orthop. (239):47-52, 1989
Mirvis SE et al: Hangman's fracture: radiologic assessment in 27 cases. Radiology. 163(3):713-7, 1987
Baumgarten M et al: Computed axial tomography in C1-C2 trauma. Spine. 10(3):187-92, 1985
Hadley MN et al: Axis fractures: a comprehensive review of management and treatment in 107 cases. Neurosurgery. 17(2):281-90, 1985
Levine AM et al: The management of traumatic spondylolisthesis of the axis. J Bone Joint Surg Am. 67(2):217-26, 1985
Sherk HH et al: Clinical and pathologic correlations in traumatic spondylolisthesis of the axis. Clin Orthop. (174):122-6, 1983
Pepin JW et al: Traumatic spondylolisthesis of the axis: hangman's fracture. Clin Orthop. (157):133-8, 1981
Seljeskog EL et al: Spectrum of the hangman's fracture. J Neurosurg. 45(1):3-8, 1976
Marar BC: Fracture of the axis arch. "Hangman's fracture" of the cervical spine. Clin Orthop. (106):155-65, 1975
Williams TG: Hangman's fracture. J Bone Joint Surg Br. 57(1):82-8, 1975
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Synonyms
Traumatic spondylolisthesis of axis (TSA)
Definitions
Fractures through bilateral C2 pars interarticularis
Avulsion of C2 body from facets, neural arch
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Patel JYK et al: Unstable hangman's fracture: anterior or posterior surgery? J Craniovertebr Junction Spine. 10(4):210-5, 2019
Al-Mahfoudh R et al: Management of typical and atypical hangman's fractures. Global Spine J. 6(3):248-56, 2016
Hadley MN et al: Introduction to the guidelines for the management of acute cervical spine and spinal cord injuries. Neurosurgery. 72 Suppl 2:5-16, 2013
Ryken TC et al: Management of isolated fractures of the axis in adults. Neurosurgery. 72 Suppl 2:132-50, 2013
Pryputniewicz DM et al: Axis fractures. Neurosurgery. 66(3 Suppl):68-82, 2010
Yanni DS et al: Fixation of the axis. Neurosurgery. 66(3 Suppl):147-52, 2010
Congress of Neurological Surgeons: Isolated fractures of the axis in adults. Neurosurgery. 50(3 Suppl):S125-39, 2002
Congress of Neurological Surgeons: Management of combination fractures of the atlas and axis in adults. Neurosurgery. 50(3 Suppl):S140-7, 2002
Ranjith RK et al: Hangman's fracture caused by suspected child abuse. A case report. J Pediatr Orthop B. 11(4):329-32, 2002
Harrop JS et al: Acute respiratory compromise associated with flexed cervical traction after C2 fractures. Spine. 26(4):E50-4, 2001
Samaha C et al: Hangman's fracture: the relationship between asymmetry and instability. J Bone Joint Surg Br. 82(7):1046-52, 2000
Agrillo U et al: Hangman's fracture. Spine. 24(22):2412, 1999
Guiot B et al: Complex atlantoaxial fractures. J Neurosurg. 91(2 Suppl):139-43, 1999
Josten C: [Traumatic spondylolisthesis of the axis.] Orthopade. 28(5):394-400, 1999
Williams JP 3rd et al: CT appearance of congenital defect resembling the Hangman's fracture. Pediatr Radiol. 29(7):549-50, 1999
Greene KA et al: Acute axis fractures. Analysis of management and outcome in 340 consecutive cases. Spine. 22(16):1843-52, 1997
Nunez DB Jr et al: Cervical spine trauma: how much more do we learn by routinely using helical CT? Radiographics. 16(6):1307-18; discussion 1318-21, 1996
Starr JK et al: Atypical hangman's fractures. Spine. 18(14):1954-7, 1993
James R et al: The occurrence of cervical fractures in victims of judicial hanging. Forensic Sci Int. 54(1):81-91, 1992
Parisi M et al: Hangman's fracture or primary spondylolysis: a patient and a brief review. Pediatr Radiol. 21(5):367-8, 1991
Burke JT et al: Acute injuries of the axis vertebra. Skeletal Radiol. 18(5):335-46, 1989
Fielding JW et al: Traumatic spondylolisthesis of the axis. Clin Orthop. (239):47-52, 1989
Mirvis SE et al: Hangman's fracture: radiologic assessment in 27 cases. Radiology. 163(3):713-7, 1987
Baumgarten M et al: Computed axial tomography in C1-C2 trauma. Spine. 10(3):187-92, 1985
Hadley MN et al: Axis fractures: a comprehensive review of management and treatment in 107 cases. Neurosurgery. 17(2):281-90, 1985
Levine AM et al: The management of traumatic spondylolisthesis of the axis. J Bone Joint Surg Am. 67(2):217-26, 1985
Sherk HH et al: Clinical and pathologic correlations in traumatic spondylolisthesis of the axis. Clin Orthop. (174):122-6, 1983