HANGMANS INJURY

By : Linda Lugina Luthfi Rizky Pranoto Nova Cecilia Raden Achmad Candra

HANGMANS INJURY
A broken neck involving a fracture of an upper cervical vertebra similar to the injury suffered in death by hanging. The fracture always affects the vertebra called the axis -- the second cervical vertebra (C2) -with or without subluxation (slippage) of C2 on C3

 The mechanism of injury - a sudden forceful hyperextension centered just under the chin occurs mainly with deceleration injuries in which the victim's face or chin strike an unyielding object with the neck in extension.

Neurologic assessment of C2 fractures (C2 nerve root)

Motor: Muscles that have a contribution from the C2 nerve root include the sternocleidomastoid, trapezius, longus capitis, longus colli, rectus capitis anterior, splenius capitis, splenius cervicis, and semispinalis capitis. Sensory: The C2 nerve root provides sensory innervation to the posterior scalp, anterolateral neck, and anteroinferior and posteroinferior external ear. Reflexes: The sternocleidomastoid (SCM) reflex, which may be elicited by tapping on the clavicular end of the muscle.

Type 1
Caused by axial loading and hyperextension. The PLL and ALL of the fracture remains intact which makes it a stable fracture. The right treatment for this one is to use a cervical collar. Aside from taking medicines for pain relief, this collar functions much like a fracture cast because it keeps the patient immobilized Treatment in a cervical orthosis 6 weeks

Type of cervical collars

Type 2
Most common & unstable Hyperextension axial loading injury The ALL and the PLL sustained some damage, as well as the C2 and C3 disks Reduce in traction -> Halo Vest This is a brace that holds the skull in metal braces in order to immobilize the neck.

Halo vest

Type 2a
This is an instable fracture that has severe angulation, or movement of the bones to other places. A fracture surgery would be a good option for this.

Type 3
Most Unstable This is characterized by severe angulation and displacement Moreover, the C2/C3 disk is dislocated This is considered as an unstable fracture that again needs surgery and correction.

Orthotic prescription for patient