Hangman骨折损伤病理特点及颈前路钢板内固定治疗  

Traumatic pathomorphology and anterior plate fixation of hangman's fractures

作　　者：蔡贤华[1] 陈庄洪[1] 黄继锋[1] 刘曦明[1] 徐峰[1] 黄卫兵[1] 王庆[1] 时宏富[1] 

机构地区：[1]广州军区武汉总医院骨科,430070

出　　处：《临床外科杂志》2007年第5期349-351,共3页Journal of Clinical Surgery

摘　　要：目的探讨Hangman骨折的损伤病理特点与治疗方法。方法Hangman骨折21例，其中双侧椎弓对称性骨折16例，一侧经椎体后缘骨折5例；Ⅱ型骨折14例，ⅡA型6例，Ⅲ型1例；伴颈2椎弓周围骨折6例、颈脊髓不全损伤4例。均采取颈2～3前路植骨融合钢板内固定治疗。结果本组骨折均伴不同程度的颈2～3椎间盘、前、后纵韧带损伤；术后3～4个月，骨折及颈2～3椎间均骨性愈合，随访1～4．5年，颈椎活动及神经功能均恢复良好。结论Hangman骨折呈双侧对称或非对称性骨折，常伴颈2～3椎间盘、韧带及颈2椎弓周围骨损伤，导致颈2～3失稳，颈前路钢板内固定为其理想的治疗方法。Objective To explore the traumatic pathologic feature and treatment of hangman＇s fractures. Methods Twenty - one cases of hangman＇s fractures,including 14 cases of type Ⅱ ,6 cases of type Ⅱ A and 1 case of typeⅢ, were treated surgically by anterior plating of C2 - 3 with reduction and interbody fusion. Of them, 16 were suffered from symmetrical fractures in both sides of vertebral arch,and 5 trans- posterior margin fractures of the axis in one side. Six cases were associated with fracture of peri - arcus vertebrae of axis,and 4 with incomplete injury of cervical spinal cord. Results All of them had injuries of C2 - 3 intervertebral disc and anterior and posterior longitudinal ligaments to varying degrees. Solid bone fusion was achieved in all fractures and C2 - 3 intervertebral spaces in postoperative 3 - 4 months. Function recovered very well in cervical activity and spinal nervous during a follow - up of 1 - 4.5 years. Conclusion Hangman＇ s fracture, usually accompanied with the injuries of C2 - 3 disc, ligament and fracture of peri- arcus vertebrae of axis, may be symmetrical or asymmetrical fracture and result in instability of axis. Anterior plate fixation is reliable treatment for hangman＇s fractures.

关 键 词：HANGMAN骨折 损伤 外科治疗 内固定 

分 类 号：R687.3[医药卫生—骨科学]