Spine: Hangman fracture: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Spine: Hangman fracture

Sample item

A passenger in a head-on collision has neck pain, and the lateral cervical radiograph shows bilateral fractures through the pars interarticularis of C2 with anterior displacement of C2 on C3. What is the mechanism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Hyperextension with axial distraction or loading

Traumatic spondylolisthesis of the axis (Hangman fracture) results from hyperextension and distraction as in judicial hanging, or hyperextension and axial loading as in road accidents. Most are treated in a collar or halo, and neurological deficit is uncommon because the canal widens.

Option by option

  • A. Pure flexion

    Pure flexion produces other patterns such as facet dislocation.

  • B. Hyperextension with axial distraction or loading (correct)

    Correct. Hyperextension with axial force is the mechanism.

  • C. Axial compression with the neck flexed

    Axial compression with flexion produces burst or wedge fractures.

  • D. Rotational force on the atlas

    A rotational force on the atlas produces rotatory subluxation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Hyperextension with axial distraction or loading. Traumatic spondylolisthesis of the axis (Hangman fracture) results from hyperextension and distraction as in judicial hanging, or hyperextension and axial loading as in road accidents.

Why is "Pure flexion" not the answer?

Pure flexion produces other patterns such as facet dislocation.

Why is "Axial compression with the neck flexed" not the answer?

Axial compression with flexion produces burst or wedge fractures.

Why is "Rotational force on the atlas" not the answer?

A rotational force on the atlas produces rotatory subluxation.

What concept does this question test?

It tests Spine: Hangman fracture in Orthopaedics. Most are treated in a collar or halo, and neurological deficit is uncommon because the canal widens.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spine: Hangman fracture?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.