Woman goes home after hosp fixes ‘hangman’s fracture’
Times of India | 30 December 2025
Kolkata: A 56-year-old woman from south Kolkata, who sustained a near-fatal injury called a hangman's fracture after her dupatta got entangled in the rear wheel of a toto, underwent a complex neurosurgery at a city hospital a week ago. The homemaker is now back home.
The woman had landed on the road after her dupatta got entangled in the wheel. By the time she was rushed to Manipal Hospital Dhakuria, doctors found a severe strangulation injury that caused multiple rib fractures and facial fractures, along with a dangerous cervical spine injury known as a Type 2 odontoid fracture (a break in the upper part of the neck) that can instantly damage the spinal cord and is commonly referred to as a hangman's fracture. Doctors said this kind of injury has a high mortality rate, with complications like sudden paralysis or instant cardiac arrest due to spinal cord compression.
A medical team led by Nirup Datta, consultant - neurosurgery, and Prakhar Gyanesh, consultant - anaesthesiology, decided on emergency stabilisation surgery to save the patient and prevent paralysis. Imaging tests, including an X-ray and CT scan, confirmed that the fracture was highly unstable, with two open breaks in the upper cervical vertebrae, making movement of the neck extremely dangerous. Because strangulation injuries usually cause immediate fatal damage to the spine due to the sudden backward bending and pulling forces on the neck, survival itself is rare.
The doctors performed a highly specialised and relatively new technique known as Kotil's Procedure, a method of fixing the broken neck bones from the back of the neck using screws on both sides of the first two cervical vertebrae (C1 and C2). On one side, they placed a C1–C2 transarticular screw, which passes through the joint to hold the neck bones firmly in place, and on the other side, they performed a posterior odontoid screw fixation, where a screw is placed from behind to secure the broken tip of the odontoid bone to the body of the C2 vertebra.
This approach is aimed at providing very strong stability in a region that is extremely delicate.
Doctors claimed that Kotil's Procedure is used in only a few centres worldwide and, so far, only about 15 cases have been reported in medical literature.
"A hangman-type fracture caused by strangulation often leads to immediate death. The fact that the patient survived long enough to reach us was extraordinary. Kotil's technique gave us the best chance to save her life without her experiencing any neurological trauma," said Datta, who conducted the surgery.