External orthosis as exclusive treatment for hangman's fracture type II. Case report

Authors

  • Ernesto Enrique Horta-Tamayo Holguín University of Medical Sciences. Mariana Grajales Coello Faculty of Medical Sciences. Lucía Iñiguez Landín Clinical-Surgical Hospital. Holguín, Cuba. https://orcid.org/0000-0002-1292-1689
  • Diana Rosa Ortega-Raez Holguín University of Medical Sciences. Mariana Grajales Coello School of Medical Sciences. Lucía Iñiguez Landín Clinical-Surgical Hospital. Holguín, Cuba. https://orcid.org/0000-0002-6992-3570
  • Enrique Antonio González-Hernández Holguín University of Medical Sciences. Mariana Grajales Coello School of Medical Sciences. Lucía Iñiguez Landín Clinical-Surgical Hospital. Holguín, Cuba. https://orcid.org/0000-0002-4062-653X

Keywords:

hangman's fracture, traumatic spondylolisthesis of the axis, conservative treatment

Abstract

Introduction: Fractures of the axis are the most common injuries to the upper cervical spine. Traumatic spondylolisthesis is a bilateral fracture of the pars interarticularis of C2. Its management is controversial.
Case report: A 58-years-old male patient was brought to the emergency department due to a height falling. During the initial evaluation, neurological deficit was not found, but the patient refered pain when moving his neck in a rotational direction. A Minerva rigid cervical orthosis was immediately placed on him and cervical x-rays was taken, which showed traumatic spondylolisthesis of the axis grade II. Initially was offered surgical treatment but the patient refused. In this case, a rigid cervical immobilization scheme was used for at least 16 weeks. During the follow-up period, serial x-rays showed fusion of C2-3. The patient was asymptomatic throughout this period, but with discomfort due to immobilization. The external orthosis was used until week 20th. Ten months after treatment the patient's functional performance was similar to that before the accident, with no signs of pseudoarthrosis.
Conclusions: Conservative management of this patient with traumatic spondylolisthesis of the axis type II with external orthosis had favorable results.

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Author Biographies

Ernesto Enrique Horta-Tamayo, Holguín University of Medical Sciences. Mariana Grajales Coello Faculty of Medical Sciences. Lucía Iñiguez Landín Clinical-Surgical Hospital. Holguín, Cuba.

Second Degree Specialist in Neurosurgery

Diana Rosa Ortega-Raez, Holguín University of Medical Sciences. Mariana Grajales Coello School of Medical Sciences. Lucía Iñiguez Landín Clinical-Surgical Hospital. Holguín, Cuba.

First Degree Specialist in Neurosurgery

Enrique Antonio González-Hernández, Holguín University of Medical Sciences. Mariana Grajales Coello School of Medical Sciences. Lucía Iñiguez Landín Clinical-Surgical Hospital. Holguín, Cuba.

First Degree Specialist in Neurosurgery

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Published

2025-04-15

How to Cite

1.
Horta-Tamayo EE, Ortega-Raez DR, González-Hernández EA. External orthosis as exclusive treatment for hangman’s fracture type II. Case report. Acta Méd Centro [Internet]. 2025 Apr. 15 [cited 2025 Oct. 10];19(1):e2036. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/e2036

Issue

Vol. 19 (2025): PUBLICACIÓN CONTINUA

Section

Case Reports

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