A 28-year-old man presents with neck pain after a road traffic accident. Lateral cervical radiograph shows bilateral fractures through the pars interarticularis of C2 with mild anterior displacement of C2 over C3. What is this injury called?

• A Jefferson fracture
• B Teardrop fracture
• C Clay-shoveler's fracture
• D Hangman's fracture ✓

Explanation

Bilateral pars fractures of the axis with forward subluxation of C2 on C3 constitute hangman's fracture, also termed traumatic spondylolisthesis of the axis. It results from hyperextension and distraction forces, historically judicial hanging. A Jefferson fracture is a burst of the atlas ring, a clay-shoveler's fracture avulses the spinous process of a lower cervical vertebra, and a teardrop fracture is a flexion injury of the subaxial cervical spine.

Reference: Apley's System of Orthopaedics and Fractures, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.