前路融合钢板内固定治疗不稳定的Hangman骨折

摘要

目的 探讨前路融合内固定手术治疗Hangman骨折的疗效.方法 2005-12-2009-12我科应用前路融合钢板内固定治疗Hangman骨折13例,男10例,女3例,年龄24～58岁,平均37.4岁.Levine-EdwardsⅡ型7例,Ⅱa型4例,Ⅲ型2例.术前使用Halo-vest架复位固定.患者颈前右侧入路显露C2-3间隙,减压后植入自体髂骨块或椎间融合器并行钢板内固定.结果 术后未发现血管神经损伤并发症,X线片显示骨折均达到解剖复位,骨性愈合时间在3～4个月,颈部旋转屈伸功能正常,未发现内固定断裂及松动.结论 前路减压植骨内固定治疗不稳定的Hangman骨折,融合固定可靠,无须长期卧床或佩戴Halo氏架,是一种效果确切的治疗方法.%Objective To evaluate the result of anterior road cervical operation to treat Hangman's fracture. Methods From December 2005 to December 2009,13 patients with Hangman's fracture were treated. 10 male,3 female,age ranged from 24 to 58 years with average of 37.4 years. 7 patients classified as type Ⅱ ,4 patients as type Ⅱa, 2 patients as type Ⅲ injuries respectively according to Levine-Edwards classification. To maintain reduction by apply Halo-vest crutch. A anterior right approach to exposure C2_3,discectomy and decompression of C2_3,fusion,plate internal fixation were carried. Results There were not any early or late post-operative complications. All cases gained bony fusion about 3-4 months. Internal fixation provides good reduction and stability to Hangman's fracture. It is not imperative to stay in bed and to wear Halo-vest crutch for a long time. Conclusions C2-3 anterior road fusion and plate fixation is a good method to treat Hangman's fracture, maintaining excellent reduction and achieve stability.