C2 vertebral fracture. A 78-year-old lady had been in a car crash. Even the slightest bending of the cervical spine caused pain. The x-ray shows a hangman-type fracture in the right arch of the C2 vertebra. In addition, there is a class III type dens fracture in the body of the C2 vertebra. The dens is slightly tilted towards flexion. This is a typical hyperextension injury. The treatment consisted of a halo vest, i.e. a support frame attached to the skull with screws.Picture source: Medimage / University of Turku. By courtesy of the Finnish Ministry of Education.