Hyperextension cervical spine injury - Hangman and extension teardrop fractures

Discussion:

The case illustrates different forms of hyperextension cervical injuries.

Hyperextension cervical injuries are not uncommon and extremely serious.

Hangman fracture, also known as traumatic spondylolisthesis of the axis, is a fracture which involves the pars interarticularis of C2 on both sides, and is a result of hyperextension and distraction.

Extension teardrop fracture typically occurs due to forced extension of the neck with resulting avulsion of the anteroinferior corner of the vertebral body. Extension teardrop fractures are stable in flexion and unstable in extension as the anterior longitudinal ligament is disrupted. Extension teardrop is not considered as severe as flexion teardrop fractures.

Atlanto-axial rotatory subluxation

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