| 经口咽入路钢板内固定治疗不稳定性寰椎骨折 |
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投稿时间：2012-04-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 孙韶华 |
SUN Shao-hua |
宁波市第六医院脊柱外科,浙江 宁波 310053 |
Department of Orthopaedics,Ningbo No.6 Hospital,Ningbo 315040,Zhejiang,China |
54216055@qq.com |
| 方剑利 |
FANG Jian-li |
宁波市第六医院脊柱外科,浙江 宁波 310053 |
Department of Orthopaedics,Ningbo No.6 Hospital,Ningbo 315040,Zhejiang,China |
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| 马维虎 |
MA Wei-hu |
宁波市第六医院脊柱外科,浙江 宁波 310053 |
Department of Orthopaedics,Ningbo No.6 Hospital,Ningbo 315040,Zhejiang,China |
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| 刘观燚 |
LIU Guan-yi |
宁波市第六医院脊柱外科,浙江 宁波 310053 |
Department of Orthopaedics,Ningbo No.6 Hospital,Ningbo 315040,Zhejiang,China |
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| 期刊信息：《中国骨伤》2013年，第26卷，第1期，第81-84页 |
| DOI：10.3969/j.issn.1003-0034.2013.01.021 |
| 基金项目: |
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中文摘要:
目的：分析应用经口咽入路钢板内固定治疗不稳定性寰椎骨折的临床疗效及安全性.
方法：2007年7月至2011年6月,应用经口咽入路钢板内固定治疗不稳定性寰椎骨折8例,男6例,女2例;年龄23～48岁,平均39.5岁;高处坠落伤5例,交通伤3例.双侧寰椎前弓骨折(前1/2 Jefferson骨折,Landells type I)3例,单侧寰椎前后弓双骨折(半环Jefferson骨折,Landells type II)3例,双侧寰椎前后弓双骨折伴单侧侧块骨折(Landells typeⅢ)2例.
结果：所有患者获得随访,时间6～24个月,平均13个月.患者的临床症状均得到不同程度的改善.平均手术时间为98 min(80～140 min);平均出血量为200 ml(100～300 ml);平均透视时间55 s;术中术后均未发生神经、椎动脉损伤和其他手术相关并发症.复查X线片及CT,未发现患者上颈椎失稳或复位丢失,螺钉位置良好,无松动、断钉.
结论：经口咽入路采用寰椎侧块螺钉固定钢板重建寰椎前环是治疗不稳定性寰椎骨折的一种可靠及安全的方法.它既保持了寰枢关节的旋转运动功能,同时又恢复了寰枕关节和寰枢关节的协调运动. |
| 【关键词】寰椎 骨折 骨折固定术,内 外科手术 |
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| Transoral plate internal fixation for treatment of instability atlas fracture |
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ABSTRACT
Objective:To evaluate the efficacy and safety of transoral plate internal fixation for instability atlas fracture.
Methods:A retrospective study was performed in eight patients with instability atlas fractures,who were treated by a transoral plate internal fixation from July 2007 to June 2011. There were 6 males and 2 females,with an average age of 39.5 years old ranging from 23 to 48 years. Among them,5 case were falling injury,3 cases were traffic accident injury. Three patients had bilateral fractures of the anterior arch (prehalf Jefferson fractures,Landells type I),5 had anterior arc fracture associated posterior arc fracture (Half-ring Jefferson fractures,Landells type Ⅱ),and 2 had anterior and posterior arc fracture associated with single lateral mass fractures ( Landells type Ⅲ).
Results:All patients were followed up for 6 to 24 months after operation (averaged 13 months),and all the patients had the clinical symptoms improved to some extent. Operation time ranged from 80 to 140 min (averaged 98 min); the intra-operative blood loss was 120 to 300 ml (averaged 180 ml);and the average fluoroscopic time was 55 s. No patients happened neurological and vertebral artery injuries-related complications or other complications after operation. The followed-up X-ray and CT manifested osseous fusion in all the 8 patients,no loosening or breakage of the screws.
Conclusion:Transoral plate internal fixation for instability atlas fracture is a reliable and safety technique that allows maintenance of rotatory mobility in the C1,2 joint and restoration of congruency in the atlanto-occipital and atlanto-axial joints. |
| KEY WORDS Atlas Fractures Fracture fixation,internal Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 孙韶华,方剑利,马维虎,刘观燚.经口咽入路钢板内固定治疗不稳定性寰椎骨折[J].中国骨伤,2013,26(1):81~84 |
| 英文格式: | SUN Shao-hua,FANG Jian-li,MA Wei-hu,LIU Guan-yi.Transoral plate internal fixation for treatment of instability atlas fracture[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(1):81~84 |
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