A bipedicular fracture of the second cervical vertebra, often with a concomitant dislocation of the vertebra. The term hangman’s fracture stems from properly performed judicial hangings. At the moment when the dropped victim fully extends the rope, the hangman’s knot causes fracture dislocation of the upper cervical spine and transection of the spinal cord or medulla. If the knot is not made or applied properly, death is usually due to asphyxia. Contemporary hangman’s fractures primarily occur as the result of automobile accidents or athletic competitions.