+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

An abused five-month-old girl: Hangman's fracture or congenital arch defect?

An abused five-month-old girl: Hangman's fracture or congenital arch defect?

Journal of Emergency Medicine 29(1): 61-65

Hangman's fractures are a rare finding in childhood. In case of suspected or proven child abuse, differentiation with a congenital defect of the posterior arch of C2 is essential. We present the case of a 5-month-old girl, who had a history of being physically abused by one of her caretakers. On the lateral view of the cervical spine, a defect of the posterior elements of C2 and an anterolisthesis of C2 on C3 was seen. CT scan showed a bilateral defect in the posterior elements of C2. No soft-tissue swelling of hematoma was noted. MRI showed a normal signal intensity of the intervertebral disc C2-C3. No haematoma was noted. Clinical examination revealed a slight head lag and local tenderness; there were no neurological deficits. This case shows that the differentiation between a congenital C2 arch defect and a hangman's fracture is precarious. In this case the findings on MRI and CT scan were interpreted as a congenital posterior arch defect (spondylolysis).

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 048224532

Download citation: RISBibTeXText

PMID: 15961011

DOI: 10.1016/j.jemermed.2005.01.008

Related references

A congenital defect resembling the Hangman's fracture. Spine 16(10): 1240-1241, 1991

CT appearance of congenital defect resembling the Hangman's fracture. Pediatric Radiology 29(7): 549-550, 1999

Hangman's fracture in an abused infant: imaging features. Pediatric Radiology 27(9): 776-777, 1997

Fracture of the axis arch. "Hangman's fracture" of the cervical spine. Clinical Orthopaedics and Related Research .(106): 155-165, 1975

The hangman's fracture. Fractures of the neural arch of the axis. Radiology 104(2): 303-307, 1972

The Dens-Arch synchondrosis versus the Hangman's fracture. Pediatric Radiology 8(2): 100-102, 1979

Difficulties in distinguishing between an atlas fracture and a congenital posterior atlas arch defect in postmortem analysis. Forensic Science International 242: E1-E5, 2014

Congenital vertebral arch defect with compensatory hyperplasia of adjacent arch parts. Archiv für Orthopadische und Unfall-Chirurgie 49(6): 607-609, 1958

Surgical repair of blunt force penetrating anogenital trauma in an 18-month-old sexually abused girl: a case report. European Journal of Obstetrics Gynecology and Reproductive Biology 153(2): 231, 2010

Fracture of the anterior arch of the atlas associated with a congenital cleft of the posterior arch. Demonstration by CT. Neuroradiology 30(5): 444-446, 1988

Congenital absence of the posterior arch of the atlas associated with a fracture of the anterior arch. Journal of Bone and Joint Surgery. British Volume 92(9): 1300-1302, 2010

Interruption of the aortic arch with aortico-pulmonary septal defect and intact ventricular septum in a teenage girl. Chest 60(4): 324-327, 1971

Congenital microvillus atrophy in a 4-month-old girl. Turkish Journal of Pediatrics 41(4): 495-500, 2000

Congenital Panfollicular Nevus in a 6-Month-Old Girl. Pediatric Dermatology 33(2): E137-E139, 2017

A case of congenital teratoma in a 3-month-old girl. Akusherstvo i Ginekologiia 37: 100-101, 1961