Dear Editor,
Traumatic spondylolisthesis of the axis, which consists of bilateral fractures of the C-2 pedicles and subluxation of C-2 on C-3, has been termed the “hangman’s fracture”. The earliest evidence of a formal execution by hanging is found in Homer’s Odyssey, written between 800 and 600 BCE [3], and the submentally placed knots, which are known as the hangman’s knots, were used in judicial hangings in Britain from the nineteenth century [1]. Creating a fracture-dislocation of C-2 on C-3, it delivers a certain, instant and painless death. A hangman’s fracture is the very condition that hangmen should strive to achieve [2].
A hangman is a person who hangs another, i.e., a hanger. The “hangman’s fracture”, coined by Schneider et al. [5] in 1965, is produced by a hangman but suffered by a hanged man. Although there are no definite rules how to establish eponymonic nomenclature, signs, diseases, and/or syndromes are usually named after those who describe them first or suffer them commonly (e.g., Parkinson’s disease, Jefferson fracture, farmer’s lung disease, clay-shoveler’s fracture, etc.). From this point of view, a more appropriate name for the “hangman’s fracture” may be “hanged-man’s fracture” [4]. However, either a hangman or a hanged man is not necessarily a male. The conventional name of “hangman’s fracture”, therefore, should be “hanged-person’s fracture”.
Accordingly, we suggest that a more suitable terminology for the so-called “hangman’s fracture” may be the “hangee’s fracture”.
References
de Zouche Marshall JJ (1888) Judicial executions. BMJ 2:779–786
Garfin SR, Rothman RH (1989) Traumatic spondylolisthesis of the axis (hangman’s fracture). In: The Cervical Spine Research Society (eds) The cervical spine, 2nd edn. JB Lippincott, Philadelphia, pp 344–354
Haughton S (1866) On hanging, considered from a mechanical and physiological point of view. Philos Mag J Sci 32:23–34
Niijima K (1991) Hangman’s fracture vs. Hanged-Man’s fracture. J Neurosurg 75:669
Schneider RC, Livingston KE, Cave AJ, Hamilton G (1965) “Hangman’s fracture” of the cervical spine. J Neurosurg 22:141–154
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Niijima, K., Huang, JC. Hangman’s fracture vs hanged-man’s fracture vs hangee’s fracture. Acta Neurochir 155, 819 (2013). https://doi.org/10.1007/s00701-013-1622-3
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DOI: https://doi.org/10.1007/s00701-013-1622-3