• Chee-Kidd Chiu, Chris Yin-Wei Chan, Lim-Beng Saw, and Mun-Keong Kwan.
• Orthopedic Surgery, Clinical School, International Medical University, Seremban, Malaysia. cheekidd@yahoo.com.
• Eur J Trauma Emerg S. 2010 Apr 1;36(2):180-2.

BackgroundInjury to the cervical spine due to a scarfassociated accident has not been reported in the literature. We present a case of a hangman's fracture in a 43-year-old woman that resulted from a scarfrelated injury as a consequence of a motor vehicle accident.PurposeTo identify the mechanism of a scarf-related injury causing Hangman's fracture.Case ReportA 43-year-old woman was involved in a motor vehicle accident. She was wearing a scarf, which is a common clothing accessory for women in Malaysia. The scarf was violently torn off her head during the injury, causing a type I hangman's fracture. A halo vest for a total period of 3 months was applied.ConclusionA scarf-related injury can cause an injury that resembles judicial hanging, leading to a traumatic spondylolisthesis of the axis. Careful evaluation of the cervical spine radiographs is crucial as occult fracture of the axis can be missed.

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