摘要
目的初步比较经颈前路单枚单头螺纹中空加压螺钉与双头螺纹中空加压螺钉内固定治疗齿突骨折的效果。方法1997年4月～2003年4月,对20例齿突骨折行经颈前路单枚中空加压螺钉内固定术,其中单头螺纹中空加压螺钉12例,双头螺纹中空加压螺钉8例。Anderson分型:Ⅱ型16例,浅Ⅲ型4例。其中3例伴有单侧椎间关节内撕脱性骨折。观察手术时间、术中出血量、术后骨折愈合以及颈部活动情况。结果手术时间110～150min,平均125min。术中出血20～100ml,平均42ml。术中无一例发生副损伤。术后随访2～72个月,平均14.7个月;19例骨折正常愈合,1例延迟愈合;17例骨折愈合后颈椎活动恢复正常,3例伴单侧椎间关节内骨折者颈部旋转功能较正常减少20%。两种螺钉固定的手术时间、术中出血量、骨折愈合时间和颈椎活动功能无明显差别,差异无显著性(P >0.05)。结论单枚单头螺纹中空加压螺钉与单枚双头螺纹中空加压螺钉固定齿突骨折均可获得良好效果。
Objective To compare the clinical effectiveness of fixations of odontoid process fractures preliminarily with anterior single one-threaded and double-threaded canulated compressive screws. Methods From April 1997 to April 2003, 20 cases of odontoid process fracture were fixed internally by anterior approach with single canulated compressive screws. The patients were all males with the age of 18 to 56 years. All the patients had a history of head trauma prior to fracture. The interval from injury to diagnosis was averagely 3.7 days ranging from 0 to 8 days. All of the patients complained of pain in posterior part of neck, and 6 cases with mild numbness of both hands. Of these cases, 16 were Anderson type Ⅱ and 4 were shallow type Ⅲ. 18 fractures were dislocated less than 25%, while 3 patients were associated with unilateral intervertebral joint avulsed fracture. As the diagnosis were established, skull traction were installed at once. Only after the fracture was reduced and became stable more than 5 days confirmed by bedside X-ray examination, could the operation be performed. 12 cases were fixed with one-threaded canulated compressive screws, and the other 8 with double-threaded canulated compressive screws. The operation time, blood loss, fracture healing and the cervical motion function were evaluated respectively. Results The operation times of the two groups were from 110 to 150 minutes (average, 125 minutes). The blood losses during operation were from 20 to 100 ml (average, 42 ml). There was no operative complication with wound healed well in the two groups. The follow-up were from 2 to 72 months with an average of 14.7 months. The fractures of 19 cases healed in an average 12.7 weeks, one of them was delayed union lasted to 17 weeks. The cervical motion function of 17 cases recovered completely after fracture union. The 3 cases associated with intervertebral joint avulsed fractures reminded mild limitation in cervical rotation by 20%. There was no difference between the two kinds of screws regarding to the operation time, blood loss, fracture healing, and cervical motion. Conclusion The effects of internal fixations of the odontoid process fractures are satisfactory either with the single one-threaded canulated compressive screw or the single double-threaded canulated compressive screw.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2003年第10期595-598,共4页
Chinese Journal of Orthopaedics
