Completely dislocated hangman's fracture with a locked C2–3 facet

Abstract

✓ The authors report a rare case of a hangman's fracture involving complete dislocation of C-2 onto C-3, accompanied by a C2–3 locked facet and asymptomatic bilateral vertebral artery injuries. The patient, a 25-year-old man who sustained a neck injury in an industrial accident, presented with a mild central spinal cord syndrome. His initial lateral cervical radiograph showed complete anterior dislocation of the C-2 body onto C-3, bilateral neural arch fractures, and a unilateral locked facet. The mechanism was likely flexion and compression. The grossly unstable spine and the locked facet were treated by posterior decompression, reduction, and C1–3 fixation. The patient recovered in several days and is without neurological deficit.