body of C3 and the posterior elements of C1 and C2. Prevention Car crashes Most commonly this can occur during a car accident. A person involved in a car crash, especially with no seat belt, can slam their chin against the steering wheel, dashboard, or windshield, causing the hyperextension to occur. Contact sports Falling and colliding with other people in a contact sport can also cause this fracture. Falling causes the weight of the body to force hyperextension. In full-contact sports such as American football and Rugby, diving for the ball can lead a player to land on his head, forcing the neck into hyperextension. The further piling of players on top of an injured player adds more weight and can lead to further occurrences of this fracture. Treatment Non-surgical or surgical Hangman's fractures treatments are both non-surgical and surgical. Benefits of surgical hangman's fracture treatment Sasso also observed that people who underwent surgical treatment will not be affected by pin site infections, brain abscesses, facet joint stiffness, loss of spinal alignment, and skin breakdown. Another study concerns the surgical treatment of the ring of axis conducted by Barsa and coauthors (2006) based on 30 cases within 41 patients treated by using anterior cervical fixation and fusion and 11 cases treated by a posterior CT. Result of the surgical treatment As a result, Barsa and coauthors showed that the result of fracture fusion reduced after one year but only one patient died of other disease during the follow-up. Hakalo and Wronski (2008) showed the benefits of operative treatment such as using transoral C2-C3 discectomy with plate-cage stabilization or posterior direct pars screw repair for the reducing and healing process. In deliberate or suicidal hanging, asphyxia is much more likely to be the cause of death due to associated prevertebral swelling. A common sign is a constricted pupil (Horner's syndrome) on the ipsilateral side due to loss of sympathetic innervation to the eye, caused by damage to the sympathetic trunk in the neck. Epidemiology The C2 fracture accounts for nearly 19% of spinal fractures and 55% of cervical fractures (in patients with head injury). Within C2 fractures, the hangman's fracture accounts for 23% of occurrences while the odontoid or dens fracture accounts for 55% of them. Society Statistics from the AHRQ show that there were 12,532 hospital discharges from C2 fractures in the US during 2010. The mean healthcare costs were