定位引导下空心螺钉内固定治疗齿状突骨折的临床研究

Treatment of dens fracture with cannulated screw fixation under locational guidance

目的评价定位引导下空心螺钉内固定治疗齿状突骨折的临床疗效。方法2005年1月-2009年1月利用齿突导针瞄准器定位引导下空心齿状突螺钉内固定27例齿状突骨折患者，其中Ⅱ型骨折19例，浅Ⅲ型骨折8例；平均随访6．5个月（3～12个月），拍摄颈椎侧位、开口位X线片并行CT检查观察骨折愈合情况。结果患者手术时间40min～1．3h，无术中并发症发生。术后所有患者均得到随访3～12个月（平均6．5个月），26例患者骨折愈合，1例患者未愈合，骨折端有骨质吸收。结论采用齿突导针瞄准器定位引导下空心螺钉内固定治疗齿状突骨折，可以使操作模式化，实现全程控制，连续、微调操作，具有手术操作简单、创伤小、疗效满意等特点。

Objective To evaluate the clinical effect of the cannulated screw fixation in treatment of the dens fracture under loeational guidance. Methods The study involved 27 patients treated with the cannulated screw fixation under locational guidance from January 2005 to January 2009. There were 19 patients with type II fracture and eight with type light III fRacture. The lateral and open mouth position X-ray examination of the cervical ventebrae was done to observe the fracture healing. Results The operation lasted for a range of 40 minutes to 1.3 hour （ average 1.0 hour） , which showed no any complications. The patients were followed up for average 6.5 months （3-12 months ） , which showed sound fracture healing in 26 patients but nonhealing in one. Conclusion The eannulated screw fixation for treatment of the dens fracture under loeational guidance is characterized by easy operation, minor trauma and satisfactory outcome.