Tap on and choose 'Add to Home Screen' to create a shortcut app

Tap on and choose 'Install/Install App' to create a shortcut app

Hangman’s Fracture in Children

This page was last updated on February 24th, 2019

  • Fracture of C2 pars interarticularis: This fracture is typically through the pars interarticularis, although in children it may be the odontoid epiphysis instead.
  • Hyperextension injury: In both adults and children, a hangman’s fracture is due to a hyperextension and distraction force.
  • Must be differentiated from pseudosubluxation: In children, it is important to differentiate from a pseudosubluxation, a condition that can be seen in up to 40% of children younger than 8 years at C2-3 and 14% at C3-4 (7).


  • Swischuk’s Line:This line is from the anterior cortical surface of the arch of C1 to the anterior cortical surface of the spinous process of C3.7. The anterior cortical surface of C2 should be on or within 1.5 mm of the line. A hangman’s fracture is suspected when it is >1.5 mm behind it. X-ray must be true lateral to evaluate.


Your donations keep us going

The ISPN Guide is free to use, but we rely on donations to fund our ongoing work and to maintain more than a thousand pages of information created to disseminate the most up-to-date knowledge in the field of paediatric neurosurgery.

By making a donation to The ISPN Guide you are also indirectly helping the many thousands of children around the world whose treatment depends on well-informed surgeons.

Please consider making a donation today.

Use the app

The ISPN Guide can be used as a standalone app, both on mobile devices and desktop computers. It’s quick and easy to use.

Fully featured

Free registration grants you full access to The Guide and host of featured designed to help further your own education.

Stay updated

The ISPN Guide continues to expand both in breadth and depth. Join our mailing list to stay up-to-date with our progress.