标准中空加压螺钉经峡部固定治疗急性hangman’s骨折

STANDARD ANNULATED SCREW FIXATION TRANS-ISTHMUS IN THE TREATMENT OF ACUTE HANGMAN'S FRACTURE

目的 :评介中空标准加压螺钉经颈2 峡部固定在治疗急性hangman’s骨折中的临床应用价值。方法 :回顾性分析我科自 2 0 0 0年 2月～ 2 0 0 1年 2月间应用AO钝钛标准加压短螺纹钉治疗急性枢椎椎弓骨折 (hang man’sfracture) 10例病人 ,hangman’s骨折Ⅰ型 3例 ,Ⅱ型 7例 ,其中 1例合并神经损伤 ,9例无神经系统症状 ,所有病人均行颅骨牵引 ,复位后用AO钝钛加压空心钉经峡部固定颈2 ,自体或脱钙骨植骨融合术。结果 :所有病人均获得满意的临床疗效 ,1例神经系统症状术后得到明显改善 ,无椎动脉损伤及其它术中、后并发症 ,术后常规摄片示复位固定满意 ,随访 3月～ 1年未见螺钉松动、脱出、断裂 ,三维螺旋CT示植骨愈合良好。结论 :AO钝钛中空加压螺钉经峡部固定治疗急性hangman’s骨折手术简单 ,复位满意、上颈椎功能损伤小 ,组织相容性好 ,为治疗急性hangman’s骨折提供了一种安全 。

Objective:To evaluate the clinical outcomes of standard annulated screw fixation through isthmus in the treatment of acute hangman's fracture. Method:Retrospective analysis ten patients of acute hangman's fracture, from February 2000 to February 2001, treated by AO standard annulated titanium screw fixation, there were six males and four females, with an average age 25.2 (from 19 to 36) years ,all patients have traumatic history, Ⅰ type 3, Ⅱ type 7, one patient with neurologic deficit, screw fixation in the level of the 2th cervical spine after reduction, bone graft (allo or autograft).Result:Neither vertebral artery injury nor spinal cord injury was experienced clinically, one patient of neurologic deficit had been improved, the status of reduction and location of screw was evaluated by radiograph, all patients followed up with an average 8(3～12) months, no found hardware failure.Conclusion:Posterior trans-isthmus of the 2th cervical spine screw insertion using image intensifier was performed safely, better reduction, less action lost in C1～2, get rapidly rescovery, so it is an effect new technique.