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Why is the 'hanging fracture' behind the hanging incident so horrifying? Can you imagine how such an injury would occur?
Hanging fracture, in layman's terms, refers to the fracture of the pedicles or intervertebral joints on both sides of the second cervical vertebra (C2). This injury is primarily caused by falls or high-impact traffic accidents, particularly when there is severe bending of the neck. For many patients who experience this fracture, the trauma is often accompanied by horrific memories and physical and mental trauma.
Causes
A Norwegian study found that about 60% of cervical fractures are caused by falls, while 21% are caused by traffic accidents. According to statistics from the U.S. Agency for Healthcare Research and Quality (AHRQ), the elderly population aged 65 to 84 faces the highest risk of C2 fractures, with 39.02% of injuries in this group caused by falls and 61% caused by traffic accidents.
Among the injured patients, women accounted for 54.45%.
Injury Mechanics
The mechanism of injury for a hanging fracture is usually forceful hyperextension of the head, with the neck stretched significantly to cause the injury. In judicial hangings, the knot is often placed under the condemned person's chin. When the person is lowered, the weight of the whole body forces the head to hyperextend, a violent process sufficient to cause fractures. Although this fracture has long been associated with judicial hangings, research shows that only a small number of hangings produce this fracture.
Common injury scenarios
In addition to hanging, the mechanism of this trauma mainly occurs when the neck is subjected to sudden and strong external force, such as when the face of a passenger or driver hits the dashboard or windshield violently in a car accident. Other common scenarios include falls, diving accidents, and collisions in contact sports. Although strangulation fractures are extremely unstable, the likelihood of survival is relatively high because they widen the spinal canal at C2, causing many patients to unexpectedly discover their fractures on X-rays.
Precautions
Traffic Accidents
In a car accident, passengers who are not wearing seat belts may suffer from head slamming against the dashboard, causing hyperextension and resulting in fractures.
Contact Sports
In contact sports, these fractures can occur from collisions between players and falls. Especially in full-contact sports such as American football and rugby, players may hyperextend their necks as they quickly lean forward to compete for the ball.
Treatment methods
Non-surgical or surgical treatment
Treatment options for strangulation fractures include both nonsurgical and surgical options. Patients who undergo surgical treatment can avoid complications such as infection and joint inflammation, and it helps accelerate fracture healing. According to multiple studies, surgical treatment is effective, with only a few patients dying from other diseases during the one-year follow-up period.
EpidemiologyA study on the effectiveness of surgical treatment showed that fracture healing was significantly improved in patients after surgery.
According to the data, C2 fractures account for approximately 19% of all vertebral fractures, of which strangulation fractures account for 23%. In 2010, there were 12,532 hospitalizations for C2 fractures in the United States, with associated medical costs of $749.5 million.
Social Impact
Statistics show that the number of hospitalizations for C2 fractures increased by nearly 250% between 2000 and 2010. This significant increase undoubtedly reflects the health risks faced by the elderly population in today's society, as well as the severity of traffic casualties.
Under such circumstances, how to further ensure the safety of the elderly and reduce the occurrence of such tragedies has become an issue that needs to be urgently addressed in modern society?
