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  • Title: Traumatic atlantoaxial dislocation with Hangman fracture.
    Author: Chaudhary SB, Martinez M, Shah NP, Vives MJ.
    Journal: Spine J; 2015 Apr 01; 15(4):e15-8. PubMed ID: 25576900.
    Abstract:
    BACKGROUND CONTEXT: Traumatic bilateral-atlantoaxial dislocations are rare injuries. Hangman fractures, conversely, represent 4% to 7% of all cervical fractures and frequently involve a combination C1-C2 fracture pattern. Presently, there is no report in the English literature of a traumatic C2-spondylolisthesis associated with a C1-C2 rotatory dislocation. This injury complex cannot be cataloged using current classification schemes and no established treatment recommendations exist. PURPOSE: To report a unique case of a Hangman fracture associated with bilateral C1-C2 rotatory-dislocation, which does not fit into existing classification systems, and discuss our treatment approach. STUDY DESIGN: A clinical case report and review of the literature. METHODS: Chart review and analysis of relevant literature. There were no study-specific conflicts of interest. RESULTS: A 26-year-old man sustained a traumatic C2-spondylolisthesis along with C1-C2 rotatory subluxation in an automobile collision. The patient was originally placed in a halo crown and vest and then taken for an open reduction and stabilization through a posterior approach for persistent C1-C2 subluxation. The patient is currently 16 months postoperative and back to work as a plumber. CONCLUSIONS: The injury complex encountered cannot be described using the available classification systems. Our treatment included initial stabilization with halo placement, followed by a posterior C1, C2, and C3 segmental reduction and fixation resulting in radiographic fusion and a good clinical outcome.
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