后路钉棒内固定非融合治疗创伤性寰枢关节旋转脱位  

Posterior screw-rod internal fixation without fusion for traumatic atlantoaxial rotatory dislocation

作　　者：成俊[1] 谭均[1] 赵耘[1] 程方东[1] 彭晓[1] CHENG Jun;TAN Jun;ZHAO Yun;CHENG Fang-dong;PENG Xiao(Dept of Orthopaedics,the Fifth Hospital of Chengdu,Chengdu,Sichuan 611130,China)

机构地区：[1]成都市第五人民医院骨科,四川成都611130

出　　处：《临床骨科杂志》2020年第2期153-156,共4页Journal of Clinical Orthopaedics

摘　　要：目的评估后路钉棒内固定非融合治疗创伤性寰枢关节旋转脱位的疗效。方法对7例创伤性寰枢关节旋转脱位患者采用颅骨牵引复位,后路钉棒内固定,不做植骨融合。影像学检查确定骨折愈合后取出内固定。评估寰枢关节复位及侧块骨折愈合情况、颈椎旋转度、颈部疼痛及有无旋转脱位复发。结果7例颅骨牵引复位均获成功。患者均获得随访,时间15~24个月。内固定术后12个月骨折愈合,无内置物松动、断裂。取出内固定3个月后,颈椎旋转度110°~150°,1例颈部仍轻微疼痛。所有患者无旋转脱位复发。结论后路钉棒内固定非融合是治疗创伤性寰枢关节旋转脱位的有效方法,可促进骨折及韧带修复,恢复寰枢关节旋转功能。Objective To evaluate the effect of posterior screw-rod internal fixation without fusion in the treatment of traumatic atlantoaxial rotatory dislocation.Methods Seven patients with traumatic atlantoaxial rotatory dislocation underwent reduction with skull traction and posterior screw-rod internal fixation without bone graft fusion.The internal fixation instruments were removed after fracture healing confirmed by imaging examination.The reduction of atlantoaxial joint,fracture healing of lateral mass,degree of cervical rotation,neck pain and recurrence of with or without rotatory dislocation were evaluated.Results Reduction were successfully achieved by skull traction in all 7 cases,they were followed up for 15~24 months.The lateral mass fracture healed at 12 months after internal fixation,without loosening or breaking of internal fixation.At 3 months following removal of internal fixation,cervical rotation was 110°~150°.One case had mild neck pain and no recurrent rotatory dislocation occurred in all cases.Conclusions Posterior screw-rod internal fixation without fusion is an effective strategy in the treatment of traumatic atlantoaxial rotatory dislocation.It can promote the repair of fracture and ligaments,and restore the rotational function of atlantoaxial joint.

关 键 词：寰枢关节脱位 旋转脱位 内固定 非融合 

分 类 号：R684.7[医药卫生—骨科学] R687.32[医药卫生—外科学]