title: Scarf-Related Hangman's Fracture: A Case Report.
abstract: BACKGROUND
  Injury to the cervical spine due to a scarfassociated accident has not been reported in the literature. We present a case of a hangman's fracture in a 43-year-old woman that resulted from a scarfrelated injury as a consequence of a motor vehicle accident.
  
  
  OBJECTIVE
  To identify the mechanism of a scarf-related injury causing Hangman's fracture.
  
  
  METHODS
  A 43-year-old woman was involved in a motor vehicle accident. She was wearing a scarf, which is a common clothing accessory for women in Malaysia. The scarf was violently torn off her head during the injury, causing a type I hangman's fracture. A halo vest for a total period of 3 months was applied.
  
  
  CONCLUSIONS
  A scarf-related injury can cause an injury that resembles judicial hanging, leading to a traumatic spondylolisthesis of the axis. Careful evaluation of the cervical spine radiographs is crucial as occult fracture of the axis can be missed.
authors.affiliation: Orthopedic Surgery, Clinical School, International Medical University, Seremban, Malaysia. cheekidd@yahoo.com.|Orthopedic Surgery, Clinical School, International Medical University Seremban, Negeri Sembilan, 70300, Malaysia. cheekidd@yahoo.com.
authors.forename: Chee-Kidd
authors.initials: CK
authors.lastname: Chiu
authors.affiliation: Orthopedic Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia.
authors.forename: Chris
authors.initials: C
authors.lastname: Yin-Wei Chan
authors.affiliation: Orthopedic Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia.
authors.forename: Lim-Beng
authors.initials: LB
authors.lastname: Saw
authors.affiliation: Orthopedic Surgery, University of Malaya Medical Center, Kuala Lumpur, Malaysia.
authors.forename: Mun-Keong
authors.initials: MK
authors.lastname: Kwan
keywords: Axis; Hangman; Spine; Spondylolisthesis; Trauma management and education
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