Zsolczai S, Pentelényi T
Magy Traumatol Orthop Helyreallito Seb. 1989;32(4):281-93.
The international literature calls "Hangman's fracture" (HF) the injury of the upper cervical spine with characteristic lesions of the epistropheus. The typical bone lesion in this injury is the bilateral fracture of the penduncles of the epistropheus, the dislocation of the arch, the luxation between CII and CIII and the injury of the disk, by chanche other additional fractures of the vertebrae CII and CIII too. Two forms are known: that of hyperextension distraction mechanism, leading to the classical death by hanging with very severe neurological lesion, and that with hyperextension compression mechanism, seen in modern traffic injury without neurological lesion or with relatively mild neurological symptoms. The later injury, seen more and more frequently in our days, appears with a rather broad spectrum and can be divided in three types. The stable injuries can be treated conservatively, the unstable injuries with Halo traction or with anterior operative methods, according to modern requirements. The prognosis is good. Authors describe their experiences, first in the Hungarian literature, gained from a critical review of the world literature and from a 11 years material.