寰椎骨折治疗进展

长期以来,寰椎骨折的治疗存在多种争议.该文在对单纯寰椎骨折机制、分型和稳定性进行文献复习的基础上,重点介绍寰椎骨折的治疗进展:对于稳定型寰椎骨折,通常采用保守治疗;对于不伴有横韧带断裂的不稳定型寰椎骨折,可依病情采取保守治疗、寰椎单节段复位固定术及寰枢、枕颈融合术;对于伴有横韧带断裂的不稳定型寰椎骨折,寰枢椎融合术或枕颈融合术是经典术式,寰椎单节段固定术的内固定效果亦受到关注,但是否可用于伴横韧带断裂的不稳定型寰椎骨折,目前仍未有令人信服的临床报道.

Current researches on the treatment of atlantal fractures

Treatment of atlantal fractures are controversy for a long time.On the basis of the review of mechanism classification and stability,treatment of isolated atlantal fractures were discussed emphatically in this paper.For stable atlantal fractures,conservative treatments are generally accepted.For unstable atlantal fractures with transverse ligament intact,conservative treatments,C1-C2 fusion,occipitocevical fusion and C1-ring osteosynthesis are available for different conditions.For unstable atlantal fractures with transverse ligament rupture,C1-C2 and occipitocevical fusion are classic operation.In addition,C1-ring osteosynthesis is concerned with certain internal fixation effect for fractures with transverse ligament rupture,but convincible clinical results are still lack until now.