颈前路植骨融合内固定治疗Ⅱ、ⅡA型Hangman骨折  

Anterior fusion with the internal fixation system in the treatment for Hangman's fracture of type Ⅱ and ⅡA

作　　者：黄惠梅[1] 蔡镇德 林松庆[2] 林晓东[1] 

机构地区：[1]晋江市医院晋南分院外科,福建晋江362241 [2]南京军区福州总医院骨一科,福建福州350003

出　　处：《临床骨科杂志》2014年第4期381-382,共2页Journal of Clinical Orthopaedics

摘　　要：目的：观察颈前路植骨融合钢板内固定治疗Ⅱ、ⅡA型Hangman骨折的临床疗效。方法对16例Ⅱ、ⅡA型Hangman骨折患者术前颅骨牵引后行颈前路植骨融合钢板内固定术。结果16例均获随访，时间12～4个月。均未出现脊髓、神经损伤，无椎动脉损伤及脑脊液等并发症，无切口感染，未发生咽喉疼痛、吞咽困难。术后3个月患者均获骨性愈合。颈椎生理曲度恢复，屈伸及旋转活动良好，无内固定系统松动、断裂现象。4例脊髓神经D级者全部恢复到E级。枕颈部疼痛均较术前明显改善。7例行取髂骨术者切口愈合良好，术区无遗留疼痛。结论颈前路植骨融合钢板内固定治疗Ⅱ、ⅡA型Hangman骨折能获得即时稳定，减压彻底，固定确实，融合满意。Objective To observe the clinical effect of anterior fusion with the internal fixation system in the treat-ment for unstable Hangman’s fractures of type Ⅱ,ⅡA. Methods 16 cases of Hangman fractures of type Ⅱ,ⅡA were involved in this study, who all underwent anterior fusion with internal fixation system after skull traction. Re-sults All patients were followed up for 12~24 months. There was no sign of injury to spinal cord, nerve roots and cervical arteries, no leak of cerebrospinal fluid, no infection, and no occurrence of sore throat and dysphagia. Three months after the operation, all patients were cured with bony union and restoration of cervical curvature, the spine movement maintained excellently. There was no sign of screw loosening and breakage. Spinal cord function was im-proved from D grade to E grade in 4 cases. Occipitocervical pain was attenuated in all patients. There were 7cases underwent anterior fusion from iliac bone, all of the incisions healed well, and there was no pain of the dornor site. Conclusions Anterior cervical fusion with internal plate fixation for treatment of unstable Hangman’s fracture can se-cure instant stability, with the advantages：complete decompression, solid fixation, satisfactory fusion.

关 键 词：HANGMAN骨折 前路融合 植骨 内固定 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]