A 56-year-old homemaker from south Kolkata has made a miraculous recovery after suffering a life-threatening neck injury, commonly known as a hangman's fracture, in a freak accident involving her dupatta. The incident occurred when the traditional scarf got entangled in the rear wheel of an electric toto, violently throwing her onto the road.
A Race Against Time to Save a Life
Rushed to Manipal Hospital in Dhakuria, the woman presented with severe injuries. Medical scans revealed the devastating extent of the trauma. She had sustained multiple rib fractures, facial fractures, and a critical cervical spine injury diagnosed as a Type 2 odontoid fracture. This specific break in the upper neck vertebrae is extremely dangerous because it can instantly compress the spinal cord, leading to sudden paralysis or even cardiac arrest. Survival from such a strangulation injury is rare due to the immediate, often fatal, damage caused by the violent backward pull on the neck.
The Complex Surgical Decision
Facing a case with a high mortality rate, a dedicated medical team led by Dr. Nirup Datta, consultant neurosurgeon, and Dr. Prakhar Gyanesh, consultant anaesthesiologist, decided immediate action was necessary. Imaging confirmed the fracture was highly unstable, with two open breaks in the upper cervical vertebrae, making any neck movement perilous. The team opted for an emergency stabilisation surgery to save the patient's life and prevent permanent neurological damage.
Executing a Rare and Specialised Technique
The surgeons performed a highly specialised operation known as Kotil's Procedure. This relatively new technique involves fixing the broken neck bones from the back. In this case, the team used a dual-approach screw fixation. On one side, they placed a C1–C2 transarticular screw through the joint to lock the vertebrae in place. On the other side, they performed a posterior odontoid screw fixation, securing the broken bone tip directly to the C2 vertebra's body.
This method provides exceptional stability in one of the most delicate regions of the human body. Dr. Datta highlighted the rarity of both the case and the procedure, noting that Kotil's technique is performed in only a handful of medical centres globally, with roughly 15 cases documented in medical literature so far.
A Remarkable Outcome and a Warning
"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," stated Dr. Datta. He explained that Kotil's innovative approach offered the best chance to save her without causing further neurological trauma. The successful surgery, conducted about a week ago, allowed the woman to return home, marking a triumph against overwhelming odds.
This alarming incident serves as a stark reminder of the potential hazards associated with long, loose clothing like dupattas and sarees when near moving vehicle parts. The woman's survival and recovery stand as a testament to advanced medical intervention and surgical skill.
