对寰椎骨折治疗策略的探讨(附28例报告)

目的：探讨寰椎骨折的治疗策略及其依据。方法：28例寰椎骨折患者，25例接受保守治疗，其中15例采用Halo-vest．10例采用颈围领，均固定3个月，去除外固定后进行颈部活动锻炼1个月，复查颈椎伸屈侧位X线片，了解寰枢关节稳定情况；另3例患者分别施行了融合术。结果：采用保守治疗的25例患者经过4～48个月随访，无论骨折是否愈合．均木发现寰枢关节不稳定的情况发生，3例接受手术治疗的患者均达到植骨融合。结论：寰椎骨折大多可采用保守治疗，并可取得良好的疗效。只有确定寰枢关节稳定性遭到破坏且无法经保守治疗恢复的时候才需要施行手术治疗。

The treatment of atlas fracture

Objective:To explore the methods and the reasons to the treatment of atlas fracture. Method:28 consecutive patients were investigated.25 received conservative treatment,15 were immobilized by Halo-vest and 10 by cervical collar.3 received surgery. Result:The 25 patients who received conservative therapy were followed 4~48 months,no atlantoaxial instability occurred.The 3 patients who received operation achieved arthrodesis. Conclusion:Atlas fracture should received conservative therapy,operation should be performed in rare cases with special reasons.