C_(2,3)椎弓根侧块解剖型钉板内固定治疗不稳定型Hangman骨折  

The C2,3 pedicle-lateral mass plate fixation in the treatment of unstable Hangman's fractures

作　　者：尹庆水[1] 李凭跃[1] 夏虹[1] 吴增晖[1] 昌耘冰[1] 权日[1] 章凯[1] 马向阳[1] 刘景发[1] 

机构地区：[1]广州军区广州总医院骨科,510010

出　　处：《中华创伤骨科杂志》2006年第11期1039-1042,共4页Chinese Journal of Orthopaedic Trauma

基　　金：广东省自然科学基金团队项目(20023001)

摘　　要：目的探讨应用C2,3椎弓根侧块解剖型钉板内固定治疗不稳定型Hangman骨折的临床疗效。方法6具新鲜C0-C4颈椎标本在脊柱三维运动实验机上测试C2,3椎弓根侧块解剖型钢板内固定术的三维稳定性,并与C2,3前路AO锁定钢板内固定组进行对比。回顾性分析自1999年3月-2005年7月采用C2,3椎弓根侧块解剖型钉板内固定术治疗25例不稳定型Hangman骨折的方法和疗效。结果生物力学测试结果显示C2,3椎弓根侧块钢板内固定组各ROM值明显小于C2,3前路钢板固定组,差异有显著性意义(P< 0．05)。所有患者获得4-78个月(平均38个月)随访,23例达解剖复位,所有患者内固定牢固,均获早期骨折愈合和远期椎间稳定融合。3例出现后凸畸形,未出现其它相关并发症。结论C2,3椎弓根侧块解剖型钉板内固定术治疗不稳定型Hangman骨折可获得骨折即时复位和C2,3的远期稳定,是治疗不稳定型Hangman骨折较为理想的方法。Objective To study the feasibility and clinical results of C2, 3 pedicle-lateral mass plate fixation in the treatment of unstable Hangman＇s fractures. Methods From March 1999 to July 2005, 25 cases of unstable Hangman＇s fracture were treated surgically using the C2, 3 pedicle-lateral mass plate. All the cases were followed up for the healing of bone and function of the cervical vertebrate. Results The average follow-up period was 38 months. Twenty-three cases had a perfect reduction. Three cases had kyphosis deformity. There were no other complications related to the operation. All the cases had a perfect early fusion of the C2 pedicle isthmus and long-term stability of C2, 3 intervertebral space. The clinic results were good. Conclusion Since the C2, 3 pedicle-lateral mass fixation can provide immediate reduction and satisfactory biomechanical stability, it is a good device for unstable Hangman＇ s fractures.

关 键 词：HANGMAN骨折 外科治疗 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]