Department of Orthopeadics (Spine Surgery), The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan Province, China.
J Orthop Surg Res. 2023 Feb 23;18(1):136. doi: 10.1186/s13018-023-03622-x.
To observe the precise anatomical location and pattern of the fracture lines in Hangman's fracture.
Three-dimensional computed CT images of 210 patients with Hangman's fracture were collected. According to the involvement of anatomical structures, the injuries were classified into facet joint injury and pure bony injury. The C2 ring was also divided into: anterior, middle, and posterior elements. The anatomical structures involvement and fracture patterns were observed.
Total 520 anatomical structures injuries were involved in 210 patients Hangman's fractures, including 298 facet joints injuries (57.3%) and 222 bony injuries (42.7%). The most common facet joints injury was superior articular facet injury of C2, and the most common pure bony injury was pediculoisthmic component fracture. The injuries of anterior element (60.6%) were more common than that of middle (20.4%) or posterior (19.0%) element. One injury in anterior element on one side and another injury located in the anterior, middle or posterior element other side was the most common fracture pattern. Injury of middle element on one side with another injury located in the middle or posterior element could be also observed.
In Hangman's fractures, fracture lines could occur in any part of C2 ring. Facet joints injuries were more common than pure bony injuries, and the injuries of anterior element were also more common than that of middle or posterior element. The high prevalence of facet joints injuries means that most of Hangman's fractures may be involved with intra-articular injuries.
观察 Hangman 骨折的精确解剖位置和骨折线模式。
收集了 210 例 Hangman 骨折患者的三维 CT 图像。根据涉及的解剖结构，将损伤分为关节突关节损伤和单纯骨损伤。C2 环也分为前、中、后三部分。观察解剖结构受累和骨折模式。
210 例 Hangman 骨折患者共涉及 520 个解剖结构损伤，其中 298 个关节突关节损伤（57.3%）和 222 个单纯骨损伤（42.7%）。最常见的关节突关节损伤是 C2 的上关节突损伤，最常见的单纯骨损伤是椎弓根峡部骨折。前柱（60.6%）损伤比中柱（20.4%）或后柱（19.0%）损伤更常见。一侧前柱单一损伤，另一侧前、中或后柱另一损伤是最常见的骨折模式。一侧中柱损伤，另一侧中柱或后柱损伤也可观察到。
在 Hangman 骨折中，骨折线可发生在 C2 环的任何部位。关节突关节损伤比单纯骨损伤更常见，前柱损伤也比中柱或后柱损伤更常见。关节突关节损伤的高发率意味着大多数 Hangman 骨折可能涉及关节内损伤。
