摘要
目的探讨不同类型齿状突骨折的相应治疗方法及临床效果。方法对21例齿状突骨折患者根据Anderson—D’Alonzo分型进行分类,并予以不同方法治疗:Ⅰ型骨折3例行枕颌带牵引+6周后头颈胸石膏阎定;II型骨折13例行颅骨牵引复位后,齿状突中空螺钉固定;Ⅲ型骨折5例,行颅骨牵引复位后,1例行齿状突巾空螺钉固定,4例行颈后路寰枢椎椎弓根螺钉固定。结果随访6~48个月,平均9个月,骨折均获骨性愈合,未出现术后并发症。结论齿状突骨折应按类型区别处理,Ⅰ型骨折、深Ⅲ型骨折应当采用保守疗法,Ⅱ型及浅Ⅲ型骨折使用齿状突中空螺钉固定术治疗可获得满意效果,对于不适合齿状突中空螺钉治疗的浅Ⅲ型骨折,可选用颈后路寰枢椎椎弓根螺钉固定术。
Objective To discuss surgical treatment methods for different types of odontoid process fractures and evaluate their therapeutic results. Methods Twenty-one patients with odontoid process fracture were classified into three types, ie, type Ⅰ,type Ⅱ and type Ⅲ fractures accoding to An-derson-D'Alonzo classifications. There were three patients with type Ⅰ fractures treated by traction of occipital-jaw band and fixed with head-neck-chest plaster at 6 weeks and 13 with type Ⅱ fractures treated by cannulated screws following skull traction and reduction. As for five patients with type m fractures, one was fixed with cannulated screws and the other four with atlantoaxial pedicle screw after the fracture got diaolasis by skull traction. Results All oatients were fbllowed up for 6-48 months (average 9 months), which showed bony union, with no complications in all patients. Conclusions Odontoid process fractures should be treated according to different types. Conservative treatment for type Ⅰ fracture and cannulated screw fixation for type Ⅱ and low type Ⅲ fractures can attain satisfactory result. Atlantoaxial pedicle screw fixation can be an alternative for low type Ⅲ fractures that are not suitable for cannulated screw fixation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2009年第7期598-600,共3页
Chinese Journal of Trauma
关键词
脊柱损伤
颈椎
齿状突
骨折骨定术
内
Spinal injuries
Cervical vertebrae
Odontoid process
Fracture fixation, internal