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Hangman's fracture or primary spondylolysis: a patient and a brief review
M Parisi1, R Lieberson, S Shatsky
1Department of Radiology, University of California, San Francisco.
Insights
Diagnosing cervical fractures in infants is challenging as they can mimic congenital conditions. This case highlights a three-month-old infant with a subtle hangman's fracture, the youngest reported, emphasizing serial imaging for confirmation.
Area of Science:
- Pediatric Radiology
- Orthopedic Surgery
- Medical Imaging
Background:
- Cervical fractures in infants are difficult to diagnose.
- Fractures can be mistaken for congenital anomalies or normal developmental variations.
- Early and accurate diagnosis is crucial for appropriate management.
Observation:
- A three-month-old infant presented with a subtle cervical fracture.
- The fracture, a hangman's fracture, initially resembled primary spondylolysis.
- Serial plain films and computed tomography (CT) confirmed the traumatic origin.
Findings:
- This case represents the youngest confirmed instance of a hangman's fracture.
- Serial imaging studies proved valuable in identifying the subtle traumatic defect.
- The findings underscore the importance of considering traumatic injuries even in very young patients.
Implications:
- Highlights the diagnostic challenges of pediatric cervical spine injuries.
- Emphasizes the utility of serial imaging in confirming subtle fractures.
- Suggests a need for increased awareness of traumatic cervical injuries in neonates and infants.
Abstract:
Recognizing cervical fractures in the younger patient is often difficult. Potential fractures may look like congenital lesions or normal uncalcified synchondroses. We report a three month old infant with a subtle hangman's fracture which might have been confused with primary spondylolysis. The traumatic nature of the defect was confirmed by serial plain films and CT. In addition to showing the value of serial studies, we believe that this is the youngest confirmed case of hangman's fracture reported to date. The literature is reviewed.