A cervical fracture close to the base of the skull can result in a fatality. A broken neck is one of the most common fatal injuries caused by car accidents. Physicians refer to this specific type of cervical, or neck, fracture as a “hangman’s fracture.”
Clinically, a hangman’s fracture is a hyperextension injury. When hanging is used as a form of punishment, the hangman strategically places the knot under the chin of the victim so that the forces of the fall pull the body down while the knot holds the jawbone in place. Thus, the bones of the neck get stretched and pulled apart and damage or sever the spinal cord. The broken bones of the neck do not cause death. Instead, the concurrent damage to the spinal cord will cause death.
Not every broken neck is fatal. However, a broken neck is a catastrophic injury. Doctors see cervical fractures in pool diving accidents when the patient strikes his or her head on the pool floor, causing the head and neck to go backward with great force. The forces propelling the head and neck backward result in a cervical fracture.
One famous professional actor suffered a fall that broke his neck. His broken neck rendered him a quadriplegic. The man lost the ability to move all limbs and body parts below the line of the injury. Thus, the man could not move anything voluntarily, and the only bodily functions he had were above the level of his injury and those that occur involuntarily, such as his breathing and heartbeat. However, the man survived the broken neck because the damage did not sever the spinal column completely. Ultimately, the actor died as a result of complications due to his inability to move and not from a broken neck, per se.
Physicians label a hangman’s fracture based on the degree of severity. Before describing the levels of seriousness, it helps to understand that the cervical spine contains seven vertebrae and each vertebra in the cervical spine is designated C-1 to C-7. A Type I hangman’s fracture occurs in 65% of all cervical fracture cases. A Type I cervical fracture is a hairline fracture that does not disturb the vertebrae at the C-2 or C-3 levels. A Type I cervical fracture is stable and does not result in loss of mobility. The pain might not be debilitating. Accident victims have been known to walk around with a Type I cervical fracture, all the while thinking that he or she has whiplash. A Type I fracture does not have neurological side effects because the injury does not cause a narrowing of the spinal column.
Only upon radiographic examination with an X-ray, CT-scan, or MRI, can a physician diagnose a cervical fracture. Surgery might be required to repair this injury if the bone is displaced. Surgery may not be indicated if the bone is not displaced.
A Type II cervical fracture is a serious neck injury. This injury occurs in approximately 28% of all cervical fractures. A dislocated vertebra at C-2 dislodged or ruptured disc at C-2 and C-3, ligament damage, and a compression fracture at C-3 indicate a Type II cervical fracture. Surgery will likely be required to repair this injury, and the patient could suffer some neurological deficit if the break injured the spinal cord.
Finally, a Type III cervical fracture is likely fatal, or if not, is a catastrophic injury that has severe neurological implications. A Type III cervical fracture is present in about 7% percent of all cases. A Type III cervical fracture is fatal or can cause paralysis because the bones break and dislocate, putting pressure on the spinal cord.
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