What Is A Hangman’s Fracture?
A hangman’s fracture is a type of stress reaction that occurs when there is too much force applied to the spine or other bones during an impact. The bone may break because of excessive compression, shearing forces, or both. There are many types of fractures, but all are characterized by abnormal deformation (bending) of the bone.
Hangman’s Fractures: Causes And Symptoms
The causes of hangmen’s fractures vary depending on which part of the body was impacted. When a person falls from great height, they will most likely experience multiple impacts with their spine. However, if the fall occurred at a low enough speed, then some of these impacts could result in a fracture.
Injuries caused by falling from high places include:
Spinal injuries such as spinal stenosis and meniscal tears. These can cause pain and deformity of the spine. They are often misdiagnosed as back problems since they don’t involve any ligaments or tendons.
Soft tissue injuries such as sprain and strains, or bone injuries such as stress fractures, hairline fractures, or hanging man’s fractures.
Hangman’s fractures often occur during a fall from great height, although it may also be caused by low speed accidents such as slipping and falling. Low speed hangman’s fractures are more common in children since their bones are still developing.
When a hangman’s fracture occurs, there is often back and neck pain with numbness and tingling in the legs. In some cases, a person may also experience weakness or loss of sensation. There may be visible deformity in the back, neck, shoulders, or skull.
This type of bone injury can also cause postural imbalance which can lead to other spinal cord damage. Most people who experience hangman’s fractures will eventually recover without any complications. Others may suffer from paralysis, loss of sensation or other complications.
Hangman’s Fracture Symptoms
Hangman’s fractures are usually diagnosed through a physical examination by a medical professional or doctor. Your doctor will check if there is pain in the back, neck, shoulders, head, or legs. They will also ask about your medical history, as well as whether you’ve experienced any recent injuries or accidents.
During the physical examination, your doctor will check for:
Stiffness in the back, neck, shoulders, or head.
Pain while moving the back, neck, shoulders, or head.
Numbness in legs.
Loss of sensation in legs.
Difficulty walking or feeling tired after walking only a short distance.
A visible deformity in the back, neck, shoulders, or skull.
Treating Hangman’s Fractures
If you think you have a hangman’s fracture or are experiencing symptoms, you should seek medical attention immediately. Most hangman’s fractures do not require surgery but instead only need to be immobilized until complete healing occurs. However, some cases might require surgery.
Treatments for hangman’s fractures may include:
Immobilization of the spine with a brace or cast. The patient will probably not be able to move or feel their legs. There is also a risk of circulation impairment and tissue damage, so doctors must monitor blood flow to the legs.
Surgical fixation, which involves surgery to repair any damaged vertebrae or discs. The surgeon will use screws, rods, or other materials to stabilize and reinforce the spine.
Hangman’s Fracture Risks
Risks will depend on the type of treatment, but may include:
Injury to blood vessels or nerves in the body.
Regrowth of bones resulting in stiff, uneven movement.
Loss of feeling and loss of muscle control.
Spinal cord or nerve damage.
Difficulty walking or standing.
Hangman’s Fracture Prevention
The best way to prevent hangman’s fractures is to avoid accidents or injuries that might cause a fall. This might include:
Wearing a helmet when engaged in high-risk activities such as biking, skateboarding, horseback riding, skiing, or playing sports.
Using safety equipment while working in an area with a risk of fall.
Driving carefully and obeying traffic laws.
Hangman’s fractures are most common in children and teens, so it is important to properly store and lock hazardous materials. Lock up firearms and check playground equipment for broken or missing parts. Install gates and door latches high enough that a child cannot unlatch them. Make sure toys and bicycles are not in poor condition.
Most importantly, make sure children learn about traffic safety and take swimming lessons.
Sources & references used in this article:
What are the clinical and radiological characteristics of spinal injuries from physical abuse: a systematic review by AM Kemp, AH Joshi, M Mann, V Tempest… – Archives of disease in …, 2010 – adc.bmj.com
Anterior Displacement of C2 in Children: Physiologic or Pathologic? A Helpful Differentiating Line by LE Swischuk – Radiology, 1977 – pubs.rsna.org
Hangman’s fractures by D LeFever, SG Whipple, RP Menger – StatPearls [Internet], 2019 – ncbi.nlm.nih.gov
A coinsidence, a chance or a misfortune? Hangman’s fracture by S Dalbayrak, O Yaman – Neurologia i neurochirurgia polska, 2014 – Elsevier
An evidence-based medicine process to determine outcomes after cervical spine trauma: what surgeons should be telling their patients by P Lewkonia, C DiPaola, R Schouten, V Noonan… – Spine, 2012 – journals.lww.com