Traumatic atlantoaxial dislocation with Hangman fracture

Saad B. Chaudhary, Maximilian Martinez, Neel P. Shah, Michael J. Vives

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background context Traumatic bilateral-atlantoaxial dislocations are rare injuries. Hangman fractures, conversely, represent 4% to 7% of all cervical fractures and frequently involve a combination C1-C2 fracture pattern. Presently, there is no report in the English literature of a traumatic C2-spondylolisthesis associated with a C1-C2 rotatory dislocation. This injury complex cannot be cataloged using current classification schemes and no established treatment recommendations exist. Purpose To report a unique case of a Hangman fracture associated with bilateral C1-C2 rotatory-dislocation, which does not fit into existing classification systems, and discuss our treatment approach. Study design A clinical case report and review of the literature. Methods Chart review and analysis of relevant literature. There were no study-specific conflicts of interest. Results A 26-year-old man sustained a traumatic C2-spondylolisthesis along with C1-C2 rotatory subluxation in an automobile collision. The patient was originally placed in a halo crown and vest and then taken for an open reduction and stabilization through a posterior approach for persistent C1-C2 subluxation. The patient is currently 16 months postoperative and back to work as a plumber. Conclusions The injury complex encountered cannot be described using the available classification systems. Our treatment included initial stabilization with halo placement, followed by a posterior C1, C2, and C3 segmental reduction and fixation resulting in radiographic fusion and a good clinical outcome.

Original languageEnglish
Pages (from-to)e15-e18
JournalSpine Journal
Issue number4
StatePublished - 1 Apr 2015
Externally publishedYes


  • Atlantoaxial
  • C1-C2
  • Hangman fracture
  • Rotatory dislocation
  • Subluxation
  • Traumatic spondylolisthesis


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