[The spectrum of hangman's fracture]

The hangman's fracture is since Wood-Jones (1913) considered to be a pedicle fracture of the axial arch, combined with extensive lacerations of the intervertebral disk and the longitudinal ligaments in spine motion segment C2/3. In its mechanics it is ascribed to a non-physiological strain in the sagittal plane in particular due to added submental pressure. The various forms of strain which cause the phenomenon of the hangman's fracture are discussed in detail. In this context it appears that for the model conception chosen one must invariably also consider a rotary component. The definition of the pedicle fracture requires profound reexamination, since this topographic region manifests itself only from C3 onwards but not in the area of the axial arch. After the consideration of the location of the fracture plane the proposition is made to comply with clinical considerations instead and to define it as an intraarticular or extraarticular arch fracture. In the conclusion it is demonstrated in an exemplary manner that the monosegmental injury of the intervertebral disk and the longitudinal ligaments in the segment C2/3 considered to be typical need not be mandatory. However, if it is not present, injuries in the soft-tissue of the lower motion segments are to be expected.