title: Traumatic atlantoaxial dislocation with Hangman fracture.
abstract: BACKGROUND
  Traumatic bilateral-atlantoaxial dislocations are rare injuries. Hangman fractures, conversely, represent 4% to 7% of all cervical fractures and frequently involve a combination C1-C2 fracture pattern. Presently, there is no report in the English literature of a traumatic C2-spondylolisthesis associated with a C1-C2 rotatory dislocation. This injury complex cannot be cataloged using current classification schemes and no established treatment recommendations exist.
  
  
  OBJECTIVE
  To report a unique case of a Hangman fracture associated with bilateral C1-C2 rotatory-dislocation, which does not fit into existing classification systems, and discuss our treatment approach.
  
  
  METHODS
  A clinical case report and review of the literature.
  
  
  METHODS
  Chart review and analysis of relevant literature. There were no study-specific conflicts of interest.
  
  
  RESULTS
  A 26-year-old man sustained a traumatic C2-spondylolisthesis along with C1-C2 rotatory subluxation in an automobile collision. The patient was originally placed in a halo crown and vest and then taken for an open reduction and stabilization through a posterior approach for persistent C1-C2 subluxation. The patient is currently 16 months postoperative and back to work as a plumber.
  
  
  CONCLUSIONS
  The injury complex encountered cannot be described using the available classification systems. Our treatment included initial stabilization with halo placement, followed by a posterior C1, C2, and C3 segmental reduction and fixation resulting in radiographic fusion and a good clinical outcome.
authors.affiliation: Department of Orthopaedics, Rutgers, The State University of New Jersey-New Jersey Medical School, 140 Bergen St, ACC-D1610, Newark, NJ 07103, USA. Electronic address: chaudhs1@njms.rutgers.edu.
authors.forename: Saad B
authors.initials: SB
authors.lastname: Chaudhary
authors.affiliation: Department of Orthopaedics, Rutgers, The State University of New Jersey-New Jersey Medical School, 140 Bergen St, ACC-D1610, Newark, NJ 07103, USA.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Martinez
authors.affiliation: Department of Orthopaedics, Rutgers, The State University of New Jersey-New Jersey Medical School, 140 Bergen St, ACC-D1610, Newark, NJ 07103, USA.
authors.forename: Neel P
authors.initials: NP
authors.lastname: Shah
authors.affiliation: Department of Orthopaedics, Rutgers, The State University of New Jersey-New Jersey Medical School, 140 Bergen St, ACC-D1610, Newark, NJ 07103, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Vives
mesh_terms: D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D016103:Spinal Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013168:Spondylolisthesis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Atlantoaxial; C1–C2; Hangman fracture; Rotatory dislocation; Subluxation; Traumatic spondylolisthesis