Hangman's fracture

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  • Also known as traumatic spondylolisthesis
  • Is an unstable spine injury
  • Bilateral C2 pedicle fracture (leads to C2 displacing anteriorly on C3)

Clinical Features

Hangman's Fracture
  • Seen in MVA, diving accidents, but uncommonly judicial hangings (not in suicidal hangings)[1]
    • Forced extension of an already extended neck
  • Spinal cord damage is often minimal (diameter of neural canal is greatest at C2)

Differential Diagnosis

Cervical Spine Fractures and Dislocations


  • Xray or CT cervical


Prehospital Immobilization

See NAEMSP National Guidelines for Spinal Immobilization


  • C-collar
  • Consult ortho or spine as needed


  • Admit

See Also


  1. James, R. and Nasmyth-Jones, R. (1992) ‘The occurrence of cervical fractures in victims of judicial hanging’, Forensic Science International, 54(1), pp. 81–91