Detailed description of anatomy of the fracture line in hangman's injury: a retrospective observational study on motor vehicle accident victims

Menon, K. Venugopal; Taif, Sawsan

doi:10.1259/bjr.20150847

Cited by 11 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients were included if they ful lled all the 2 criteria: (1) patients were medically con rmed of axis ring fractures with bilateral fracture lines through any part of the bony ring, including pediculoisthmic component (PIC) fractures, posterior wall of vertebral body fractures, superior or inferior articular facets, or lamina [14,15]; (2) patients with complete imaging studies, including X-rays, axial plane computed tomography (CT) scans, sagittal and coronal plane reconstructions, and three-dimensional reconstructions of cervical spine, and all CT images were acquired using at least a 64-slice multidetector CT scanner [5]. Patients with congenital anomalies, infections, or tumors in the upper cervical spine were excluded [13,16].…”

Section: Methodsmentioning

confidence: 99%

“…They found that these fractures might occur through any part of the ring of the axis, including superior or inferior articular processes, pedicle, pars interarticularis, laminae, posterior wall of C2 vertebral body, and foramen transversarium. In addition, they also found that axis ring fracture tends to be asymmetrical [4,5]. Some other authors regarded these injuries as pedicle or par interarticularis fractures of the axis [6,7].…”

Section: Introductionmentioning

confidence: 97%

“…The variety of fracture lines and asymmetrical feature of such injuries, however, are con rmed in recently published researches [1,3,5,[8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…Ideally, surgical management for axis ring fractures should be tailored according to the fracture line location, fracture pattern, and even injury mechanism, instead of using the same technique [5,11,12]. Therefore, two questions need to be answered [5,13]: What is the precise anatomical location, pattern, and frequency of the fracture lines in axis ring fractures based on large size sample database? What is the possible injury mechanism for such fracture pattern?…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Detailed observation of axis ring fractures using computed tomography: a retrospective analysis of 202 cases

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: There is a dearth of research observing the precise anatomical location, pattern, and frequency of the fracture lines in axis ring fractures based on large size sample database and deducing the possible injury mechanism for such fractures. The study aimed to observe the anatomical features of axis ring fractures and evaluate the probable mechanism of injury.Methods: 202 patients with axis ring fractures were identified. According to the involvement of anatomical structures, the axis ring injuries were classified into facet joint injury and pure bony injury. The axis ring was also divided into: anterior, middle, and posterior elements. The anatomical structures involvement and fracture patterns of such fractures were observed using CT. Result: 501 anatomical structures of the axis ring were involved in 202 patients, including 288 facet joints injuries and 213 bony injuries. For facet joints injuries, the most common injuries were superior articular facet injuries, and for pure bony injuries, the most common injuries were pediculoisthmic component fractures. In regard to different element of the axis ring, the injuries of anterior element were more common than that of middle or posterior element. Most of (76.2%) axis ring fractures were asymmetrical, with different elements of the axis ring damaged on different side. Conclusion: In axis ring fractures, fracture lines could occur in any part of the ring. Facet joints injuries were more common than pure bony injuries, and the injuries of anterior element were more common than that of middle or posterior element. The probable mechanism of such injuries might be hyperextension and axial load, with an additional rotational load.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

“…The variety of fracture lines and asymmetrical feature of such injuries, however, are con rmed in recently published researches [1,3,5,[8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detailed observation of axis ring fractures using computed tomography: a retrospective analysis of 202 cases

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…These two methods are relatively well known; they take the appearance on lateral radiograph, degree of displacement and angulation into consideration and suggest signs for instability to assist the surgeon in choosing the optimal treatment strategy for a given case; typically, stable fractures are treated nonoperatively and unstable ones surgically. In a recent study, Menon and Taif 9 have described the fracture lines and reported a higher incidence of asymmetric fractures, frequent involvement of the foramen transversarium, facet joints and posterior vertebral body. They found the fracture pedicle on one side and pars on the other to be the commonest injury pattern followed by bilateral symmetric pedicle and bilateral symmetric par fractures.…”

Section: Introductionmentioning

confidence: 99%

Imaging findings of flexion type of hangman's fracture; an attempt for a more objective evaluation with newly introduced scoring system

Taif

Menon

Alrawi

et al. 2017

BJR

Self Cite

View full text Add to dashboard Cite

Objective: To identify the flexion type of hangman's fracture on imaging studies. Methods: 38 cases of hangman's fracture were retrospectively studied and categorized into flexion and nonflexion groups. Plain radiograph, CT and MRI of these patients were evaluated; 13 radiological parameters that might define flexion injuries were measured. The data were statistically analyzed to identify good criteria and to rank them according to their importance in predicting flexion.Results: Seven radiological criteria that have the highest correlation with flexion injury were identified. These are C2-3 lower end-plate angle, C2-3 posterior body angle, interspinous angle, disc disruption (MRI), widening of interspinous distance, disruption of the posterior ligamentous complex (MRI) and angle at the fracture site. Scoring 1 point for each positive criterion, a total score of 4 predicts flexion injury with 100% sensitivity and 96.9% specificity. Score of 5 has 83.3% sensitivity and 100% specificity. Conclusion: Flexion hangman's injury can be diagnosed by the presence of four out of seven radiological criteria in the newly introduced scoring system. The authors believe that this method may help spinal surgeons in their selection of therapeutic strategy. Advances in knowledge: This study introduces fast, simple and more objective imaging criteria for the diagnosis of flexion hangman's injury and separates it from the non-flexion pattern.

show abstract

Relevant findings on postmortem CT and postmortem MRI in hanging, ligature strangulation and manual strangulation and their additional value compared to autopsy – a systematic review

Gascho

Heimer

Tappero

et al. 2019

Forensic Sci Med Pathol

View full text Add to dashboard Cite

Several articles have described the use of postmortem computed tomography (CT) and postmortem magnetic resonance imaging (MRI) in forensic medicine. Although access to CT scanners and, particularly, access to MRI scanners, is still limited for several institutes, both modalities are being applied with increasing frequency in the forensic setting. Certainly, postmortem imaging can provide crucial information prior to autopsy, and this method has even been considered a replacement to autopsy in selected cases by some forensic institutes. However, the role of postmortem imaging has to be assessed individually according to various injury categories and causes of death. Therefore, this systematic review focuses on the role of postmortem CT and MRI in cases of hanging and ligature and manual strangulation. We assessed the most common and relevant findings on CT and MRI in cases of strangulation and compared the detectability of these findings among CT, MRI and autopsy. According to the available literature, mainly fractures of the hyoid bone or thyroid cartilage were investigated using postmortem CT. Compared to autopsy, CT demonstrated equivalent results concerning the detection of these fractures. A currently described "gas bubble sign" may even facilitate the detection of laryngeal fractures on CT. Regarding the detection of hemorrhages in the soft tissue of the neck, postmortem MRI is more suitable for the detection of this "vital sign" in strangulation. Compared to autopsy, postmortem MRI is almost equally accurate for the detection of hemorrhages in the neck. Another "vital sign", gas within the soft tissue in hanging, which is hardly detectable by conventional autopsy, can be clearly depicted by CT and MRI. The number of cases of manual and ligature strangulation that were investigated by means of postmortem CT and MRI is much smaller than the number of cases of hanging that were investigated by CT and MRI. Likewise, judicial hanging and the hangman's fracture on postmortem imaging were described in only a few cases. Based on the results of this systematic review, we discuss the additional value of CT and MRI in fatal strangulation compared to autopsy, and we reflect on where the literature is currently lacking.

show abstract

Detailed description of anatomy of the fracture line in hangman's injury: a retrospective observational study on motor vehicle accident victims

Cited by 11 publications

References 21 publications

Detailed observation of axis ring fractures using computed tomography: a retrospective analysis of 202 cases

Detailed observation of axis ring fractures using computed tomography: a retrospective analysis of 202 cases

Imaging findings of flexion type of hangman's fracture; an attempt for a more objective evaluation with newly introduced scoring system

Relevant findings on postmortem CT and postmortem MRI in hanging, ligature strangulation and manual strangulation and their additional value compared to autopsy – a systematic review

Contact Info

Product

Resources

About