Eponymous spinal fractures

This issue has come up in Question 3 from the second paper of 2005

It needs to be treated only briefly.


comparison of clay shovelers hangmans and jeffersons c-spine fractures

Jefferson fracture:

  • Burst fracture of the atlas (C1)
  • Usually combined anterior and posterior arch fractures
  • Results from axial compression of C1
  • Load of force must come from the vertex of the head, eg. diving into water head first or being thrown against the roof of a car or aircraft;
  • May also result from hyperextension
  • Unstable.

Hangman’s fracture:  

  • Bilateral fracture of the posterior arch of C2 and disruption of the C2-3 junction
  • The posterior  longitudinal  ligament may be severed
  • Due tot his, there may be significant anterior displacement of C2 on C3
  • This can sever the spinal cord at this level
  • Caused by C-spine hyperextension with vertical  compression  of  the  posterior  column
  • One scanrio suggested by  the cllege is "a car accident victim’s head striking the dashboard".
  • Unstable.

Clay-shoveller’s fracture:

  • Fracture of the spinous process only
  • An avulsion fracture by the supraspinous ligament of the spinous process caused hyperflexion.
  • Stable.


Thompson, Wendy L., et al. "Association of injury mechanism with the risk of cervical spine fractures." CJEM 11.1 (2009): 14-22.

Pimentel, Laura, and Laura Diegelmann. "Evaluation and management of acute cervical spine trauma." Emergency medicine clinics of North America 28.4 (2010): 719-738.