37 January 2019, Vol 5, Issue 1, No 16 Case Report: Hangman’s Fracture With Concomitant Atlantoaxial Dislocaon Morteza Faghih-Jouybari 1 , Jean-Charles Le Huec 2 , Foad Kazemi 3 , Kiavash Sajadi 1 , Tahereh Padeganeh 4 , Sina Abdollahzade 5* 1. Department of Neurosurgery, Sharia Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2. Orthopedic and Spine Surgery Unit Tow, Bordeaux University Hospital, Bordeaux, France 3. Department of Neurosurgery, Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran 4. Department of Maxillofacial Surgery, Sharia Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 5. Department of Neurosurgery, Shahid Rajaee Teaching Center, Qazvin University of Medical Sciences, Qazvin, Iran * Corresponding Author: Sina Abdollahzade, MD. Address: Department of Neurosurgery, Shahid Rajaee Teaching Center, Qazvin University of Medical Sciences, Qazvin, Iran Tel: +98 (28) 33320108 E-mail: sina21@gmail.com Background and Aim: Hangman’s fracture concomitant with atlantoaxial subluxaon is a rare phenomenon. Herein we report the vicm of a motor vehicle crash with traumac spondylolisthesis of the axis and atlantoaxial rotary dislocaon. Case Presentaon: The paent was a 32 year old female with the chief complaint of severe neck pain. Her neurologic examinaon was normal but did reveal mild torcollis. Imaging revealed anterolisthesis of the C2 over C3 with angulaon of C1/ C2 and rupture of the C2/ C3 disc while the integrity of the transverse ligament was preserved. The paent first underwent a paral close reducon for the dislocaon followed by the operaon focusing on the Hangman’s fracture using a 360-degree approach. An anterior discectomy of C2/ C3 with cage and plate inseron was followed by posterior fixaon using C1, C3 and C4 lateral mass screws. The one-year follow-up radiography depicted proper fusion and alignment. Conclusion: Paucity of evidence regarding simultaneous atlantoaxial dislocaon and Hangman’s fracture made its management challenging. The mechanism of injury is probably hyperextension and rotaon. Based on our presented case, anteroposterior fixaon resulted in a sasfactory long- term outcome, both clinically and radiologically. A B S T R A C T Keywords: Motor vehicle accident, Atlanto-Axial Joint, Spinal fractures Citation: Faghih-Jouybari M, Le Huec JC, Kazemi F, Sajadi K, Padeganeh T, Abdollahzade S. Hangman’s Fracture with Con- comitant Atlantoaxial Dislocao. Iran J Neurosurg. 2019; 5(1):37-42. hp://dx.doi.org/10.32598/irjns.5.1.37 : hp://dx.doi.org/10.32598/irjns.5.1.37 Use your device to scan and read the arcle online Arcle info: Received: 13 Aug 2018 Accepted: 27 Nov 2018 Available Online: 01 Jan 2019