Table 3.

Data of publication of the management of hangman’s fractures

Authors No. of patients	Year of publication	No. of death	Classification	Primary therapy	No. of conservative therapy	Anterior approach	No.of surgery Anterior + posterior	Posterior approach
Schneider et al.[31]	1965	0	No	Traction	Minerva jacket (3)	1
8				+ external immobilization	Cervical brace (2)
					Collar (1)
					Halter traction (1)
Cornish [7]	1968	1	No	Splint or traction in 3	Splint (3)	10
14				Surgery in 10
Norrell et al. [26]	1970	0	Stable	Unstable fracture were	no mentioned therapy	5
12			Unstable	treated with operation
Termansen [38]	1974	1	No	Traction or	Traction +bed rest (10)			2
19				external fixation	Plaster caster (5)
					Collar (1)
Brashear et al. [3]	1975	0	No	Traction +	Rigid immobilization (22)	1		C1-3 (3)
29				external fixation	Thomas collar (1)			C0-C3 (1)
				or operated (if large				C2-C3 (1)
				displacement remained)
Seljeskog et al. [32]	1976	3	A: single fracture of	Traction +	Traction + cervical brace (15)			1
26			laminar-pedicle (8)	immobilizatiom	Cervical brace (5)
			B: true hangman’s		Traction + halo caster +
			fracture (18)		Cervical brace (2)
			including
			no subluxation (3)
			minimal < 4mm (9)
			moderate (6)
Franscis et al. [13]	1981	0	Grade I: 19	Traction + rigid support (88)	117	4		C1-3 (2)
123			II: 9	Rigid support (35)
			III: 46
			IV: 42
			V: 7
Effendi et al. [11]	1981	9	Type I: 85	Type I: splint	Brace (Type I: 62; II: 17; III: 1)	Type I: 5		Type I: 17
131			II: 37	II: immobilization		II: 4		II: 11
			III: 9	III: if reduced, then		III: 1		III: 4
				immobilized firstly
Pepin et al. [27]	1981	4	Type I: 15	Type I: cervical collar	Brace or collar (38)
42			II: 27	or brace
				II: brace or halo
Borne et al. [2]	1984	0	A: stable without	A (rigid collar)	Rigid collar (1)			C1-3 wiring (4)
18			displacement	B (reduction +
			B:	immobilization)
			stable: with little
			displacement (< 2mm)
			unstable: with mild
			larger displacement
Roda et al. [29]	1984	0	Complete dislocation	Reduction + immobilization	Halo cast (1)
1
Levine and Edwards	1985	5	Type I: 15 (2 died)	All treated	Type I:			Type III:
[20]			II: 29 (3 died)	conservatively	Philadelphia collar (6)			C2-3 wiring (3)
52			IIa: 3		halo (7)
			III: 5		II: Philadelphia collar (4)
					halo (22)
					IIa: halo (3)
					III: halo (2)
Govender and Charles		0	Stable: 32	Stable: halter traction +	Halo or SOMI (39)
[14]	1987		Unstable: 7	collar or SOMI brace
39				Unstable: skull tong reduction +
				collar or SOMI brace
Bucholz et al. [4]	1989	0	No	Halo	Halo (12)
12
Barros [1]	1990	0	Francis Grade V	Reduction	Halo traction + Minerva cast
1				+ immobilization
Rockswold et al. [28]		0	No	Halo	Halo failure (7%)
15	1990
Tan et al. [37]	1992	0	Effendi Type I: 21,	Traction for	Effendi Type I:
34			II: 11,	at least 6 weeks	Philadelphia collar (21)
			III: 1		II: Doll’s collar (10)
					SOMI (1)
					III: SOMI (1)
Tuite et al. -[39]	1992	0	Effendi Type II: 5	Halo		5
5
Starr and Eismont.		0	Levine and Edwards	Traction + halo fixation	Halo (5)			Type II:
[34]	1993		Type I: 2	patients with complete				O-C3 fixation (1)
6			II: 4	quadriplegia not included
Coric et al. [6]	1996	0	Displacement without	A: nonrigid fixation	A: nonrigid fixation (39)	B: 1
49			combined cervical	B: nonrigid and	B: nonrigid fixation (6)
			injuries	halo fixation	halo (3)
			A: less than 6 mm (39)
			B: more than 6 mm (10)
Choi et al. [5]	1997	0	Levine and Edwards	Reduced + halo				C2-3 plate + C1-3 fusion
1			Type III
Greene et al. [15]	1997	2	Effendi Type I: 53	Reduction + external fixation	Halo (56)		Surgery (7)
74			II: 20		SOMI (6)		no said approach
			III: 1		Philadelphia collar (3)
			Francis Grade I: 48
			II: 12
			III: 11
			IV: 3
			V: 0
Verheggen and	1998	0	Levine and Edwards	Operation				Transpedicle screw (16)
Jansen [41]			Type II: 5
16			IIa: 8
			III: 3
Samaha et al. [30]	2000	0	Group 1–3	Minerva:	Minerva (15)			Plate (9)
24				displacement < 3 mm
				and no kyphosis or lordosis
				and stable on dynamic film
				Surgery:
				displacement ≥3 mm
				and kyphosis ≥15°
				or lordosis ≥5°
Taller et al. [36]	2000	0	No	Halo therapy:	Halo (7)	12		Transpedical screw (10)
29				no or 1–2 mm displacement
				Anterior surgery:
				more than 3 mm C2-3 displacement
				Posterior surgery:
				little malposition on lateral film
				while more than 3 mm on CT scan
Muller et al. [25]	2000	0	Effendi Type I: 10	Type I:	Type I:	Type II		Type II
39			II: 29	cervical orthosis	cervical orthosis (10)	flexion subset:	Listhesis subset: (2)	listhesis subset:
				II:	II: flexion subtype	anterior (1)		transpedicle screw (5)
				stable: conservative treatment	halo (7) hard collar (2)			flexion subset:
				unstable: surgery	minerva PoP (1)			transpedicle screw (1)
					extension subtype
					hard halo (2)
					listhesis subtype
					halo (8)
Marton et al. [22]	2000	1	Effendi Type I: 3	Halo except one Type I Injury	Effendi Type I: halo (2)	Effendi Type II (1)
13			II: 8	with great subluxation	II: halo (5)	II (3)
			III: 2 (1 died)		III: halo (1)
Cosan et al. [8]	2001	0	Levine and Edwards	Levine and Edwards	Levine and Edwards		Levine and Edwards	Levine and Edwards
7			Type I: 3	Type I: Philadelphia collar	Type I: Philadelphia collar (3)		IIa (1)	III: O-C2 (1)
			II: 2	II: Philadelphia collar	II: Philadelphia collar (2)	III: anterior (1)
			IIa: 1	IIa: surgery
			III: 2	III: Philadelphia collar (1)
				halo-vest (1)
Vieweg et al. [42]	2001	0	Effendi Type I: 3	Effendi Type I: stiff neck	Effendi Type I: stiff collar (3)	Effendi Type III (8)
17			II: 6	II: halo orthosis	II: halo orthosis (6)
			III: 8	III: surgery
Moon [24]	2001–2002	0	Stable: 20	Stable: halo traction +cervical orthosis	Cervical orthosis (20)	Unstable (16)		Unstable (6)
42			Unstable: 22	Unstable: surgery		(6 plated; 10 nonplated)		(transpedicle screw: 4, wiring: 2)
Vaccaro et al. [40]	2002	0	Levine and Edwards	Type II, IIa: halo	Halo (31)
31			Type II: 27
			IIa: 4
Takahashi et al. [35]	2002	0	Effendi Type III	Reduced		1
1