枢椎齿状突骨折的疗效分析

目的回顾性分析枢椎齿状突骨折的治疗方法及效果，探讨不同类型骨折治疗方法的选择。方法13例枢椎齿状突骨折患者，行颌枕带牵引复位满意后，5例行前路中空螺钉内固定术，6例后路寰枢椎融合术，1例行Halo—vest架外固定，1例行头颈胸石膏外固定。结果所有患者均获随访，随访期5—39个月。13例患者均获得满意复位，经CT三维重建或拍x线片证实11例新鲜齿状突骨折3～6个月愈合；1例后路手术者5～6个月时证实获得骨性融合；1例齿状突矢状位纵行粉碎骨折患者6个月时愈合。13例患者均无并发症发生。结论根据齿状突骨折的类型及病程，及时选择恰当的治疗方式，可获得良好的疗效。

Therapeutic effect for odontoid process fractures

Objective To summarize the treatment method and its effectiveness for odontoid process fractures and evaluate treatment options for odontoid fractures according to different fracture types. Methods Thirteen patients with odontoid process fracture were analyzed retrospectively from May 2007 to March 2010. After complete reduction, 5 patients were treated with anterior screw fixation, 6 patients with aflantoaxial fusion, 1 patient with Halo - vest fixation, 1 patient with head - neck - chest com- bined plaster fixation. Results All cases were followed up for 5 to 39 months, and they obtained complete reduction. Eleven cases with fresh odontoid process fracture were healed within 3 -6 months by X - ray and SCT scans verified, 1 case with posterior approach obtained bone fusion within 5 - 6 months, 1 case eomminuted fracture in the sagittal position of odontoid process was healed within 6 months. Thirteen cases were healed without complication. Conclusions The best selection of management which is decided by type of fraction and course of disease, can obtain excellent effect.