Florida trial lawyer and chiropractic physician, Guy S. DiMartino, DC, JD, discusses hangman's fractures after an accident.
The mechanism of injury in a hangman's fracture is forceful hyperextension (look up the ceiling) and distraction. Most commonly, the injury happens in a high speed front end collision where the person's head hits the windshield, dashboard, or steering wheel and suddenly stops causing hyperextension. A hangman's fracture can also happen if the head and neck ramps over a head rest that is not in its correct position. Again, causing a severe hyperextension of the neck.
The fracture happens to the second vertebrae in the neck called the axis. The forceful hyperextension of the head causes stress in the pedicle area of the vertebrae causing it to snap on both sides.
Signs and Symptoms of a Hangman's Fracture
Even though the condition is named after the injury that occurred from judicial hanging, a number of people who sustain these injuries in accidents do not die and do not become paralyzed. Typically, the patient will walk into a doctor's office or hospital complaining of generalized neck pain without any neurological changes. One of the reasons for the lack of neurological symptoms is because the spinal canal is pretty large in the C2 area.
A hangman's fracture can also have devastating consequences if it is not timely diagnosed and treated. These patients can end up with a spinal cord injury resulting in paralysis or death.
Treatment of a Hangman's Fracture
There are a number of treatments available for an injured person who suffers a hangman's fracture depending on the location of the fracture, the angle of the broken bones and the instability between the vertebrae, these include:
- A Halo Vest
- Surgical Fixation
People who experience a hangman's fracture from a traumatic injury can experience catastrophic injuries ranging from paralysis to death. Some folks do relatively well after injury only requiring bracing or a Halo Vest for three or so months. The issue with these cases as with all catastrophic injury cases are the long term consequences. If there is no spinal cord compromise the injured person still has to deal with the effects of traumatically induced arthritis in the future, which can lead to instability, spinal stenosis or spinal cord compromise. This usually becomes the battleground with the insurance company. The insurance company will take the position that the client is better with no real residual issues.
If you have any questions about a Hangman's Fracture after an accident, give me a call on my cell phone at (352) 267-9168. I am always available to discuss your matter or answer your questions.