What You Need to Know About Hangman’s Fracture
The spinal column is one of the parts of the body that has a lot of bones in it, called vertebrae. There are 33 of these specialized bones that are present in the spinal column. All animals with bones are called as vertebrates. Humans are definitely part of this group of animals. These vertebrae, like many other bones, are exposed to the risk of fractures. These are broken or cracked bones brought about by severe trauma from an accident, collision, or a fall. Human bones are hard that it would take a lot of external force for a bone fracture to happen. However, this does not necessarily hold true for bones that have their minerals eaten up by age or certain diseases. There are lots of fractures that are already identified, such as Galeazzi fracture which affects the arm; sacral bone fracture that refers to a crack on S1 to S5, which are sacral vertebrae; growth plate fracture that happens to the soft, developing part of the human bone; intertrochanteric fracture that is actually a crack on the hips. A fracture on any of the cervical vertebrae is another type of bone fracture that has to be dealt with.
The neck of the human body is actually made up of seven cervical bones for support. If even a single bone in the cervical vertebrae is broken, this will already qualify as a bone fracture. A dislocated bone would also be identified as fracture. In severe cases, a strong blow to the cervical vertebrae or any of the bones in the spinal column would end up being a compression fracture, which can further end up causing paralysis. This is how critical a fracture injury is when it concerns the cervical vertebrae.
There are some patterns in the way a fractured cervical bone is damaged. These are some of the patterns of how a broken neck is injured:
- Hangman’s fracture. This is a break in the cervical vertebrae that particularly affects the C2 vertebrae or the axis. Hangman’s fracture of the C2 got its name from the same fracture that was usually observed among those who were punished by hanging. Among all the other types of cervical fracture, this is rendered as the most common one. The mechanism of the injury is when the neck attempts to hyperextend but reach a hard object or surface. This hangman’s bone fracture is also strongly associated with some facial fractures.
- Teardrop fracture. This is caused by flexion injury that is identified as another compression reason. Diving is the pointed out as the main cause of this injury. The break happens to be on the anteroinferior bone. It is at the coronal plane where the fracture does happen. The risk involved with this one is when the posterior bone will continue to push for more space towards the vertebral canal. This could result to a crowded space for the spinal cord.
- Jefferson fracture. This occurs on the C1 vertebrae or the atlas. Furthermore, the fracture usually leads to even more dangerous spinal cord damage. Shallow water diving, motor vehicular accidents and falling are blamed as the usual reasons for this type of injury.
Types of Cervical Spine Fracture
Aside from the previous patterns of fracture that include hangman fracture C2, there are some other classifications of injury to the spine:
- A combined C1 and C2 fracture is common among patients with injured cervical spine. This is basically caused by axial compression and hyperextension injuries. Moreover, these two vertebrae are closely placed together that a hit or blow would likely affect both. This usually makes the fractured hangman’s bone more complicated.
- A C3 fracture of vertebrae is quite uncommon but it has one of the highest mortality rates from among other cervical injuries. Another damage that a C3 fracture can make is a paralyzed diaphragm, which could have caused the high mortality rate.
- The dens fracture of the C2 vertebrae usually occurs with a high non-union rate. A patient with this injury should have thorough mouth examination for this fracture to be confirmed.
- The vertebral canal has a narrower opening than the spinal cord. The canal is found below the C3 vertebrae, which is why more spinal injuries are caused by vertebral canal damage.
There are certain signs and symptoms that would tell people if an accident or injury already involves a fracture. The American National Emergency X-radiography Utilization Study has developed these certain points on how to evaluate a potential patient. Coherent and conscious patients without any neurological sings, without midline cervical pain, and without any severe injuries should still consult a doctor for physical examination. MRI scan and other imaging tests should be done for those that show other cervical symptoms.
In another case, an unconscious, intoxicated or uncooperative patient might have a serious fracture. Aside from x-ray, further imaging studies should be done as well. A CT scan also proves to be another reliable test as well.
Statistics in the US
Among all the spinal fractures, 20 percent is attributed to cervical spine injuries. Among a million patients with the same positive thinking, only 4.45 percent have cervical injuries that should call for hangman’s fracture treatment, or any other cervical injury treatment. The C2 vertebrae are also the most commonly affected bones, resulting to more C2 hangman’s fracture, when it comes to cervical fractures and 55 percent of these cases are the dens fracture.
A patient who just came from a doctor’s appointment is likely to have been cleared already and is ready for rehabilitation. A simple complain of pain in the neck right after an injury happens should be reason enough to got to a clinic and undergo some diagnostic tests, such as x-ray, CT scan, and the like.
Some diagnostic tests would use x-ray machines that have the three-view series – anteroposterior view, lateral view the C-spine, and the open mouth odontoid. X-rays cannot be done to unconscious patients with broken hangman’s bones or but fortunately, a CT scan is doable. This also applies to patients with unconscious patients with odontoid fracture. An MRI scan is necessary if hangman’s fractures are not detected and no pain is felt because the imaging machine can show the spinal cord.
Hangmans Fracture Treatment
After identifying hangman fracture classification, or some other cervical spine fractures, the right way to treat hangman’s fracture and any other cervical fractures can be determined. As long as the classification of the fracture is done, the treatment can start. There are various treatment options that are available but the right one depends on the location of the fracture of cervical spine, fracture stability, spinal nerves involved, spinal cord involvement, and affected vertebral artery.
There are several types of fractures with different ways on how to heal them. Most likely, patients would like to know how to treat hangman’s fracture quick. Others would even ask for a possibility of treating the fracture naturally, but in some cases, only first aid treatment can be done at home. After the diagnosis of the hangman’s injury, the doctor would also be able to estimate the fracture healing time. Thus, these types of hangman fracture treatment, if done properly, should have a reasonable recovery time.
- Type I. The PLL and ALL of the fracture remains intact which makes it a stable fracture. The right treatment for this one is to use a cervical collar. Aside from taking medicines for pain relief, this collar functions much like a fracture cast because it keeps the patient immobilized.
- Type II. The ALL and the PLL sustained some damage, as well as the C2 and C3 disks. Thus, this is an unstable fracture that should use a halo vest. This is a brace that holds the skull in metal braces in order to immobilize the beck.
- Type IIA. This is an instable fracture that has severe angulation, or movement of the bones to other places. A fracture surgery would be a good option for this.
- Type III. This is characterized by severe angulation and displacement. Moreover, the C2/C3 disk is dislocated. This is considered as an unstable fracture that again needs surgery and correction.
After surgical procedures and the removal of the cast or braces, rehabilitation should start. In some cases, exercises are allowed to complete the rehab effort. Being patient is necessary with hangman’s fracture healing time.