Hangman's fracture refers to a fracture of which cervical vertebra?

• A. C1
• B. C2
• C. C3
• D. C4

Answer: (B)

Hangman's fracture is a fracture of the axis, the second cervical vertebra. The name reflects the injury pattern that occurs with hyperextension and axial loading, producing a bilateral fracture through the pars interarticularis of C2 and often with anterior displacement of C2 on C3. The atlas (C1) is typically spared, which distinguishes this from other cervical injuries. Fractures at other levels or the C1 injury known as a Jefferson fracture have different patterns and names, so the vertebra involved here is the second one.