Atypical hangman's fracture with concomitant subaxial fracture-dislocation treated with circumferential fusion of C2-C5-a case report

Don't Hang Around, It Could Be Incidental: A Case Report of Hangman's Fracture and Review of the Literature

Neck injury fractures are commonly associated with high-impact trauma, such as motor vehicle accidents or falls from heights. However, this case underscores that it is possible to sustain such a fracture even from minor falls. As of now, there are no such reported cases. This case report highlights the importance of a thorough medical history when assessing patients with neck pain following falls. A 59-year-old male experienced a fainting episode after suffering from vomiting and diarrhea, resulting in him hitting his head. The patient attributed his neck pain to a sudden twisting of his neck. The pain originated from the base of his skull, primarily on the left side, extending to the scalp and the left shoulder. After enduring four days of intense pain that limited his ability to rotate his neck and bend to tie his shoes, he sought medical attention and underwent a neck CT scan, which led to the diagnosis of a "hangman's fracture." This injury was diagnosed in a clinical setting. Healthcare providers should inquire about the circumstances of the fall, the patient's position, associated symptoms, and any relevant pre-existing conditions. This approach ensures an accurate diagnosis and timely treatment. Comprehensive history-taking is essential for identifying high-risk situations and preventing complications that may arise from overlooked minor falls, ultimately enhancing patient safety, especially in cases of neck and spine injuries.

Fracture Dislocation at the Level of C6-C7: A Case Report and Literature Review

Fractures of the cervical spine can cause devastating long-term effects on patients. Spinal cord injuries can occur in up to 50% of cases in association with cervical spine fractures. Therefore, it is vital and of utmost importance to recognize cervical spine injuries early on to avoid the exacerbation of an existing injury and its detrimental effects on the patients. We report a case of a C6-C7 fracture dislocation with an associated neurological insult that improved dramatically following fixation and rehabilitation. Unfortunately, patients with this presentation may have long-term neurological insults rather than regain normal function; however, our case notes the importance of prompt intervention and its effect on the outcome.

Case of pedicle lag screw fixation for oblique axis body and pars fractures with displacement

Background:

Multiple axis fractures with instability are rare and appropriate treatment modalities have not been established.

Case Description:

A 33-year-old male presented with severe neck pain, bilateral upper-extremity numbness, and brisk reflexes in both lower extremities of 14 days’ duration after a car accident. The cervical CT revealed an oblique C2 body fracture and asymmetrical neural ring fractures, while the MRI showed a normal C2-3 disk. As traction failed to reduce the fracture, the patient underwent an anterior retropharyngeal approach to release the fracture fragments, followed by posteriorly passing bilateral C2 pedicle lag screws. Eight months later, the patient exhibited full range of motion across the C1-2 level with fusion of the previously noted fractures.

Conclusion:

A 33-year-old male with an unstable C2 body fracture and asymmetrical neural ring fractures successfully underwent an anterior retropharyngeal approach to release the fracture fragments, followed by posteriorly passing bilateral C2 pedicle lag screws to achieve stability/fusion.