Hangman's fracture

By Stuart M. Smith, MD and B. James McCallum, MD

Timothy Spall starred as Britain's last hangman, Albert Pierrepoint, in the excellent 2005 film, Pierrepoint. He was a master of 'the fracture'.

Hangman’s fracture is unique among this top ten list in that it is named for a disorder caused by hangman, rather than being a malady hangmen are prone to acquire.

As it turns out, a long drop with a quick stop is a bit more scientific than is usually believed. One is looking for a happy medium between too short a drop, which results in strangulation, and too long a drop, which results in decapitation.

The hangman’s fracture is actually a fracture of the second cervical vertebra, also called the axis. This fracture usually goes right through the spinal cord, causing a quick death without too much mess.

A good hangman knew to make sure that the noose was looped just under the jaw and that the knot should be located beneath the ear, but how did he know how far to make the drop? Well, the British Home Office published a handy “Official Table of Drops”, which gave a suggested length of rope for individuals of different weights. Adjustments are also made if the person being hanged had prior neck surgery or previously had their throat cut as too far of a drop could cause the healed incision to tear open, showering the spectators with blood.

If you're curious, traditional "long drop hanging" started with a drop length of eight feet for eight stone in weight (112 lbs) and decreased the length by 2 inches for every increase of seven pounds. The "modern drop" began in 1913 and starts at eight feet, with decrease of two to four inches of drop for every increase of seven pounds weight.

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