The Journal of Bone and Joint Surgery, Vol 57, Issue 7 879-887, Copyright © 1975 by Journal of Bone and Joint Surgery, Inc
Fractures of the neural arch of the axis. A report of twenty-nine cases
R Brashear, G Venters and ET Preston
Twenty-nine patients with fractures of the neural arch of the axis
(hangman's fracture) were followed for an average of six years.
Hyperextension and longitudinal compression were probably the forces most
frequently causing this injury. Serious neurological damage was uncommon;
none of these patients had any neural deficit at follow-up. In addition to
the six patients in this series who were treated by surgical fusion, the
remaining twenty-three patients, treated by traction and immobilization,
all regained a stable cervical spine. Because healing of the fracture of
the neural arch or spontaneous interbody fusion between the axis and the
third cervical vertebra invariably occurs, surgical treatment of this
injury is seldom if ever necessary.