Orthonotes
Orthonotes
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v3.0 Fusion
v3.0 Fusion
trauma topic hub

Levine–Edwards — Hangman’s (Traumatic Spondylolisthesis of Axis)

Type I: 3 mm and/or angulation (disc injury) — traction/halo or surgery. Type IIa: flexion–distraction variant (marked angulation). Type III: with C2–3 facet dislocation — unstable, surgical.

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Type I: <3 mm translation, minimal angulation — stable (collar). Type II: >3 mm and/or angulation (disc injury) — traction/halo or surgery. Type IIa: flexion–distraction variant (marked angulation). Type III: with C2–3 facet dislocation — unstable, surgical.
MCQs

High-yield practice questions

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Question 1

What is the primary mechanism of injury for a Hangman's fracture?

Question 2

Which type of Levine-Edwards classification indicates a stable injury with less than 3 mm of translation?

Question 3

In a Type II Hangman's fracture, what is the status of the C2-C3 disc?

Question 4

What is the recommended initial treatment for a Type I Hangman's fracture?

Question 5

What distinguishes a Type IIa from a Type II Hangman's fracture?

Question 6

Which type of Hangman's fracture is characterized by C2-C3 facet dislocation?

Question 7

What is the union rate for Type I Hangman's fractures treated with a collar?

Question 8

Which ligament is primarily intact in a Type I Hangman's fracture?

Question 9

What is the typical follow-up imaging duration for patients with Type I Hangman's fractures?

Question 10

What is the surgical treatment recommended for a failed halo vest reduction in a Type II Hangman's fracture?