寰枢椎椎弓根螺钉固定治疗上颈椎损伤

目的总结枕骨、枢椎椎弓根钉棒系统或寰枢椎椎弓根钉棒系统固定用于治疗上颈椎损伤的效果。方法对16例上颈椎损伤患者术前常规行颅骨牵引复位。术中寰枢椎椎弓根的进钉点选择在寰椎后结节中点旁开18~20 mm、后弓上缘下4 mm交点处。矢状面上螺钉向头侧倾斜约5°。冠状面垂直。枢椎进钉点为枢椎关节突根部中点,钉道与矢状面夹角为20°~25°,与横断面夹角30°~35°。椎弓根螺钉φ3.5 mm,寰椎、枢椎椎弓根螺钉长24~28 mm,术中遇阻力大时随时调整方向。结果平均手术时间110 min。术前Frankel分级C级1例,D级4例,术后均恢复至E级。随访6~38个月,16例全部植骨融合,内固定无松动。结论枕骨、寰枢椎椎弓根螺钉固定融合治疗上颈椎损伤是一种新技术,具有固定牢固、固定节段短和三维固定的优点。

Atlantoaxial transpedicle screws fixation for the treatment of upper cervical injury

Objective To investigate the effect of distal tibial comminuted fractures treated with closed reduction and interlocking nail.Methods 22 patientes who suffered from tibial comminuted fractures at lower segment were taken treatment with this method.Results After 6~23 months follow-up,all patients had been healed up after 3~9 months,average of 4.3 months.And outcomes were evaluated according to the criteria of Johner-Wruh,abd the results were excellent in 12,good in 9,and poor in 1.Conclusions Closed reduction and interlocking nailing for distal tibial comminuted fractures can improve the rate of bone union and reduce complications of operation.