齿状突骨折的手术治疗

目的　报告齿状突骨折的内固定及融合方法。方法　对 8例齿状突骨折患者行内固定治疗 ,其中 5例新鲜骨折行前路空心螺钉内固定 ,3例齿状突陈旧性骨折行后路经关节突螺钉 (Magerl法 )加钛缆线Gallie法内固定并取髂骨植骨融合术。 结果　经过 2～ 16个月 ,平均 6 1个月的随访 ,5例齿状突新鲜骨折均愈合 ,临床症状完全消失 4例 ,明显改善 1例。颈部旋转活动良好 5例。 3例陈旧性骨折环枢椎融合良好 ,临床症状消失 2例 ,明显改善 1例 ,颈部旋转活动部分障碍 2例 ,障碍 1例。结论　前路空心螺钉内固定技术的主要优越性在于保留了环枢椎的生理活动功能 ,后路经关节突螺钉 (Magerl法 )与钛缆线Gallie法联合固定保证了上颈椎的稳定性

Surgical Treatment of Odontoid Fracture

Objective To introduce the surgical technique of direct anterior approach or atlantoxial transarticular internal fixation with screw in odontoid process fracture.Methods Eight adult patients with odontoid fractures,5 cases were treated through anterior approach,3 cases of atlantoxial transarticular with screw internal fixation,and followed up for two to sixteen months with a average of 6.1 months.Results Five patients with fresh fracture had a bony union.Previous symtoms disappeared completely in four cases and one showed significant improvement.No limatation of cervial montion was found. of 3 cases of atlantoaxial fusion,2 had their previous symtoms disappeared completely and 1 showed significant improvement,all found limtation of cervical montion. Conclusion The major advantage of this technique is the preservation of physiological motion at atlantoaxial joint.Atlantoaxial transurticular screw fixation is stable and atlantoaxial fusion is a successful method.