经口入路复位内固定治疗不稳定性Jefferson骨折  

Transoral reduction and internal fixation in the treatment of unstable Jefferson fractures

作　　者：尹庆水[1] 夏虹[1] 吴增晖[1] 马向阳[1] 艾福志[1] 章凯[1] 王建华[1] 

机构地区：[1]广州军区广州总医院骨科医院,510010

出　　处：《中国骨科临床与基础研究杂志》2012年第6期405-410,共6页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：军队医学科学技术研究"十二.五"计划(BWS11C065);军队临床高新技术重点项目(2010gxjs032)

摘　　要：目的探讨经口入路复位内固定术治疗不稳定性Jefferson骨折的临床效果。方法自2006年2月至2012年3月广州军区广州总医院采用自行研制的Jefferson骨折复位内固定钢板(JeRP),经口入路复位内固定治疗15例不稳定性Jefferson骨折,其中寰椎环3处断裂8例、2处断裂7例,均有断端移位合并寰椎旋转脱位。术中利用JeRP复位器进行复位、四孔钉板固定。术后颈托制动2.5～3.0个月。结果 15例患者口咽部伤口均一期愈合,无不良反应。随访8～77个月,平均18个月,全部患者获得解剖复位,骨愈合良好,关节复位良好,颈椎活动正常。结论经口咽入路JeRP复位内固定术是治疗不稳定性Jefferson骨折的良好方法,可使骨折块解剖复位,恢复寰枕及寰枢关节的对合关系,重建其稳定性,同时保留上颈椎运动功能。Objective To study the clinical effect of transoral reduction and internal fixation in the treatment of unstable Jefferson fractures with Jefferson fracture reduction and internal fixation plate （JeRP）. Methods From Februrary 2006 to March 2012, 15 patients of unstable Jefferson fractures with displacement of fractured ends and atlantal rotatory dislocation were treated by self-designed JeRP through transoral approach in Guangzhou General Hospital of Guangzhou Military Command, including 3 parts breakage of atlantoaxial ring in 8 cases and 2 parts breakage in 7 cases. JeRP reductor was used to reduce the dislocation, and the quadripuntal screw plate was used to immobilize at the anterior ring and the lateral masses of C1 vertebra. Postoperative cervical collar braking was performed for 2.5 to 3.0 months. Results Oropharynx wounds got primary healing without any adverse reactions in 15 cases. All patients were followed up from 8 to 77 months, with the average of 18 months. They achieved anatomic reduction, good fracture healing, retained joint function with normal cervical motion. Conclusions Transoral reduction and internal fixation with JeRP is a good method for the treatment of unstable Jefferson fractures, which could obtain anatomic reduction of fractured bone block, restore congruency and reconstruct the stability of atlantooccipital and atlantoaxial joint, and simultaneously reserve the motion function of upper cervical spine.

关 键 词：寰椎 脊柱骨折 脱位 骨折固定术 内 经口入路 

分 类 号：R687.3[医药卫生—骨科学]