前入路空心螺钉内固定治疗齿状突骨折的解剖学测量及临床应用

目的测量国人齿状突相关解剖学数据,指导临床齿状突骨折前路空心螺钉内固定术,探讨前入路空心螺钉内固定术治疗齿状突骨折的价值及作用。方法在100例中国成人干燥枢椎标本上,对与临床齿状突骨折前路空心螺钉内固定术相关的数据进行解剖学测量,同时临床采用前路空心螺钉内固定术治疗齿状突骨折16例。结果齿状突高度(14.57±1.21)mm,齿状突基底部横径(9.06±0.87)mm,齿状突基底部前后径(10.46±0.97)mm,齿状突后倾角(11.9±5.3)°,钉道后倾角(17.2±4.8)°。临床应用前路空心螺钉内固定治疗齿状突骨折16例,随访6～40个月,全部病人均获得骨性愈合,无并发症。结论绝大多数国人齿状突只能容纳1枚3.5mm直径中空螺钉,前路空心螺钉内固定使齿状突骨折端加压,骨折愈合率高,并发症低。

Anatomic study and clinical application of anterior hollow screw fixation in the treatment of odontoid fracture

Objective To provide anatomic data for management of odontoid fracture with anterior screw fixation, and to discuss the value and effect of anterior hollow screw fixation in the treatment of odontoid fracture. Methods Direct measurements were taken from 100 dried human C2 vertebrae. The parameters related to anterior screw fixation of odontoid fracture were measured.16 patients with odontoid fracture were treated with anterior screw internal fixation. Results The length of odontoid process was(14.57±1.21)mm,the coronal diameter of the fundus of odontoid process was(9.06±0.87)mm,sagittal diameter was(10.46±0.97)mm, the posterior angulation of odontoid process relative to the coronal plane was(11.9±5.3)°,The posterior angulation of the screw placement relative to the coronal plane was(17.2±4.8)°. All 16 patients with odontoid fracture underwent anterior screw internal fixation.Following-up ranged from 6-40 months,the fracture in all cases were bony healed and no complication. Conclusion Most of Chinese are suitable for only one-screw odontoid fixation. Anterior hollow screw internal fixation can give compression to the odontiod fracture,with high fracture union rate and low complication rate.