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What is a Hangman’s Fracture?

By Matt Lalande in Catastrophic Injuries, Hamilton Personal Injury Lawyer on November 19, 2022

What is a Hangman’s Fracture?

A C2 Hangman’s fracture is a spinal cord injury that occurs when the C2 vertebra is dislocated or fractured, which can happen due to a fall, car accident, or another type of impact. According to the Canadian Spinal Cord Injury Registry, there are approximately 600 new cases of C2 Hangman’s fractures each year, resulting in about 1,200 people with symptoms as serious as quadriplegia injuries. For working individuals, C2 Hangman’s Fracture can mean the loss of employment and a devastating reduction in quality of life.

If you have been involved in an accident that has resulted in a spinal cord injury, it is important to seek medical attention immediately. Recovery from C2 Hangman’s Fracture requires specialized treatment and rehabilitation, which can can take a tremendous amount of time and be very costly. If your injury has been caused by someone a negligent person or company, our experienced personal injury lawyers at Lalande Personal Injury Lawyers can help you navigate the process and fight for the compensation you deserve.

What is the C2?

Your vertebrae are grouped into sections. They are named and numbered from top to bottom according to their location along the backbone:

  • Cervical vertebrae 1–7: from the base of the skull to the bottom of the neck
  • Thoracic vertebrae 1–12: the upper back (attached to the ribcage)
  • Lumbar vertebrae 1–5: the lower back
  • Sacral vertebrae 1–5: the hip area
  • Coccygeal vertebrae 1–4 fused: in the tailbone

The C2 is one of the bones that make up the spine and is located in the cervical spine, the upper part of the spine that extends from the base of the skull to the top of the shoulder blades. The cervical spine consists of seven vertebrae (C1 to C7), with the C2 vertebra located at the base of the skull. The C1 and C2 vertebrae are special because they are the only vertebrae in the spine that are fused together, with other vertebrae separated by intervertebral discs. This C1-C2 fusion provides stability to the head and allows for a wide range of motion, like turning the head from side to side or nodding up and down. An injury to the cervical spine can mean a loss of function in the arms and legs and potentially cause paralysis.

What is the C2 hangman’s fracture?

In a Hangman’s fracture occurs when the C2 vertebra is dislocated or fractured. The C2 vertebra is located at the base of the skull, and the fracture can occur when the head is suddenly jerked forward or backward, which can occur when the C2 vertebra is compressed, such as in a car accident. A C2 Hangman’s fracture is a serious injury that can result in quadriplegia, which is paralysis of all four limbs. In some cases, the C2 fracture can also damage the spinal cord, which can cause paralysis below the injury site. The fracture most often occurs with trauma – such as in car, truck, pedestrian, bicyucle and motorcycle accidents, or falls. The fracture causes damage to the spinal cord which leads to paralysis of respiratory muscles and quite often, often death. Below is a photo of a hangman’s fracture:

Causes of C2 Hangman’s Fracture

C2 Hangman’s Fracture is categorized as a spinal cord injury (SCI) which can be caused by a number of factors, including car accidents, falls, and sports injuries. Spinal cord injury (SCI) is defined as damage to the spinal cord that results in a loss of function, such as mobility or feeling. In the case of a C2 Hangman’s Fracture, the damage occurs when the bones in the neck are fractured or dislocated, resulting in a loss of function in the arms and legs.

Car accidents are responsible for the majority of C2 Hangman’s Fractures. According to the Canadian Spinal Cord Injury Registry, car accidents account for approximately 38% of all cases. Car accidents are the most common traumatic event in Canada, which are events that can cause physical or psychological damage. The most common type of traumatic event is a car accident, but other examples include motorcycle accidents, pedestrian accidents, bicycle accidents, trip and falls and assaults. Traumatic events can cause a range of injuries, including spinal cord injuries such as C2 Hangman’s Fractures. Falls, such as slips and falls on slippery roads during winter, are the second leading cause of C2 Hangman’s Fracture, accounting for approximately 28% of all cases. 8% of C2 Hangman’s Fractures in Canada are the result of sport injuries, from contact sports such as hockey and football to non-contact sports such as skiing and gymnastics. Cases of domestic violence or assault are responsible for approximately 5% of C2 Hangman’s Fracture cases and recreational accidents, such as trampoline accidents or diving into shallow water, account for 4% of C2 Hangman’s Fracture cases.

No matter the cause, suffering a C2 Hangman’s Fracture can have a significant impact on your life. For a working individual, C2 Hangman’s Fracture can mean work disability as a result of the symptoms of this serious injury.

Common symptoms of a C2 Hangman’s Fracture

While all spinal cord injuries (SCI) can result in serious consequences, C2 Hangman’s Fractures are particularly debilitating. The C2 vertebra is located at the base of the skull and is responsible for supporting the head. It is also responsible for protecting the spinal cord, a bundle of nerves running from the brain down the spine. The C2 vertebra is unique in that it is the only vertebra that does not have a disc between it and the C1 vertebra, which is located just above it. This makes C2 Hangman’s Fractures particularly serious, as the bones are directly pressing on the spinal cord, without the cushion of a disc.

C2 Hangman’s fractures are also called “hyperextension injuries” because they are often caused by hyperextending the neck, which can damage the vertebrae, ligaments, and discs in the neck. The C2 vertebra is the second cervical vertebra (from the top of the spine), and it is located just below the skull. The C2 vertebra is also known as the “axis” because it allows the head to rotate. When the C2 vertebra is damaged, it can cause symptoms that may vary depending on the severity of the injury.

The symptoms of C2 Hangman’s Fracture vary depending on the severity of the injury. In some cases, the only symptom may be neck pain. However, in more severe cases, the following symptoms may be present:

  • Severe Pain
  • Numbness and tingling
  • Weakness
  • Paralysis of the arms and legs
  • Loss of feeling in the arms and legs
  • Difficulty breathing
  • Difficulty swallowing
  • Loss of bladder or bowel control

What is the prognosis for someone with a C2 Hangman’s Fracture?

There is no easy answer to this question. For some people, C2 Hangman’s Fracture may mean work disability as a result of the symptoms of this serious injury. However, for others, with proper treatment and rehabilitation, it may be possible to return to work. The percentage of individuals who are able to fully return to work after suffering a C2 Hangman’s Fracture varies depending on the severity of the injury, but it is generally low.

C2 Hangman’s Fractures often result in long-term pain, disability, and a need for personal care. Most people suffering from C2 Hangman’s Fracture require some form of long-term care, whether in-home care, nursing home care, or assisted living.

In addition to the physical and financial costs associated with C2 Hangman’s Fracture, this injury can also take an emotional toll. The loss of independence and the ability to care for oneself can be devastating. Many people who suffer from C2 Hangman’s Fracture suffer from depression, anxiety, and post-traumatic stress disorder (PTSD).

Physical therapy and rehabilitation, with the goal of helping the patient regain as much function as possible, can take months or even years. In some cases, surgery may be required to stabilize the C2 vertebrae. Even with surgery and rehabilitation, many people who suffer from C2 Hangman’s Fracture never regain full function of their arms and legs.

Complete recovery from a C2 vertebra injury is possible, but the road to recovery can be long and difficult. In some cases, people with C2 Hangman’s Fracture may require surgery to stabilize the vertebrae, followed by a period of rehabilitation. Even with treatment, some people may never regain full mobility or function. The medical treatments, therapies, and medications associated with suffering a C2 Hangman’s Fracture can cost people tens of thousands of dollars, an exorbitant amount of money for someone unable to work as a result of their injuries.

The Hangman’s Fracture is a terrible injury, but could it be worse?

The closer up the cervical spine an injury occurs, the more serious the potential injury. Surviving an injury to the C1-C4 segment of the cervical spine is remarkably rare, with only roughly 1% of patients with C1-C4 injuries surviving. An injury to the high cervical spine segment – between the C1 and C4 vertebrae, just below the base of the neck – almost always means a lifetime of disability, if not paralysis or death.

While C2 Hangman’s fractures can result in long-term pain, disability, and the need for personal care, most people with this injury will eventually recover – albeit often with a long road to recovery ahead of them. Compared with injury to the C1 or C4 vertebrae, there is a much better chance for people with a C2 Hangman’s fractures to have a much more favourable outcome. If you have suffered a C2 Hangman’s Fracture, consider yourself lucky and know there is hope for a full recovery.

If you have suffered a Hangman’s fracture, our Hamilton Personal Injury Lawyers can help.

Traumatic spinal cord injury (SCI) is a life changing neurological condition with substantial socioeconomic implications for you, your family and your care-givers. Lalande Personal Injury Lawyers have extensive experience in spinal cord injury law and have helped many people who have been injured in accidents get the compensation they deserve.

If you or a loved one has been involved in a serious accident and have suffered a hangman’s fractrure or spinal cord injury, call Lalande Personal Injury Lawyers today, toll-free, no matter where you are in Ontario at 1-844-LALANDE or local in the Hamilton / Burlington area at 905-333-8888 or fill in a contact form on our website today. Our personal injury lawyers would be more than happy to provide you and your family a free consultation and free case evaluation regarding your pain and suffering, insurance coverage, inform you of your legal rights as a car accident victim and your options concerning your car accident-related injuries and losses. Remember, we work on a contingency fee basis, meaning that if we don’t win, you don’t pay.

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