All patients with suspected or confirmed hangman’s fracture should be immobilized in hard cervical collars immediately.  Complete radiolographic examination of the cervical spine via CT scan is indicated.  A spine surgeon should be emergently consulted on all patients with hangman’s fracture because definitive management varies depending upon the type of hangman’s fracture.   Definitive treatment can be a hard collar, skeletal traction, halo vest, or open reduction internal fixation, depending on the injury classification.