Hangman’s Fracture

Like many neck injuries, a hangman’s fracture can cause you pain and discomfort in your neck. Typically due to trauma such as a car accident, it’s important to get assessed if you are experiencing symptoms. If you’re diagnosed with a hangman’s fracture, there are treatment options available that will alleviate your discomfort and get you back to the active life you love.

About Hangman’s Fracture

A hangman’s fracture is unique in that it occurs in only one specific vertebra (the bones that make up your spine) in your neck. Known as C2, this bone is reportedly the one that is damaged in the archaic practice of hanging as a means of criminal punishment, hence the name.

This fracture is almost always associated with some sort of aggressive and rapid trauma, such as a fall, car accident or sports accident. Unlike other types of spinal fractures, a hangman’s fracture actually opens up around the spinal cord, instead of moving inward, which causes compression. While the spinal cord may have a large amount of room to move in, the instability created by the breaking of this vertebra can create a situation in which the spinal cord is impinged (pinched or compressed).

Symptoms of Hangman’s Fracture

The symptoms of a hangman’s fracture are much like those of many other neck injuries and conditions. The most common symptom is pain immediately following a trauma such as a car accident. If left untreated, other symptoms can occur due to the instability of the vertebra, including increased pain, numbness and tingling in your arms or legs, paralysis and weakness, due to the bones shifting and causing compression of the spinal cord.

Diagnosis of Hangman’s Fracture

Because it’s not immediately obvious that a hangman’s fracture is the cause of your neck pain, it’s very important to seek a diagnosis as soon as possible. Your doctor will take a history, including any injuries, past or present. Your neck will be examined and you will be sent for imaging so the bones can be assessed. These imaging studies can include x-rays, an MRI, a CT scan or a combination of any of the three.

Once it has been established that you have a hangman’s fracture, your doctor will often refer you to a neurosurgeon for treatment.

Treatment Options for Hangman’s Fracture

There are numerous treatment options available for hangman’s fracture, from mild to severe. The findings of your imaging and the severity of your symptoms will determine what type of treatment is best for you.

If your fracture is minor, you may only have to wear a rigid collar for a period of time to keep your neck stable and immobilized while healing. Despite the collar, you may also be instructed to limit your activities to prevent accidental movement of the bones.

On the other end of the spectrum, if your fracture is causing instability or hasn’t responded to a more conservative treatment approach, you may be required to undergo surgery. This typically involves your surgeon making an incision in the back of your neck near the broken vertebra.

Surgical hardware known as instrumentation, made of special metallic alloys, may be used to bring your spine back into alignment and prevent the pieces of your vertebra from moving apart and causing serious damage. Fusion involves using bone grafts to connect two or more vertebrae, creating a “bridge” that will provide strength and stability. All neck surgeries require that you be put under general anesthesia.