OBJECTIVETo explore the clinical effect of Hook-screw combination treatment for the unstable Hangman's fracture.

METHODSFrom March 2005 to May 2008, 17 patients with unstable Hangman's fracture, of whom there were 15 males and 2 females aged from 28 to 75 years old with an average age of 46 years, were treated by Hook-screw combination. Of injury reasons, there were 8 patients caused by falling injury, 5 patients caused by traffic accident injury, 3 patients by tumble and 1 patient by crash injury of heavy object. Type of bone fracture: there were 3 patients with type II, 5 patients with type I a and 9 patients with type Ill. The level of nerve injury according to ASIA criteria, there were 3 patients with grade C, 5 patients with grade D and 9 patienst with grade E.

RESULTSAll patients were followed up for 3 to 22 months averaged 8 months. All patients were recover completely without upper cervical spine pain and C2, C3 loss of reduction. No patients' nerve function was injured in the patients with normal function before operation. The patients with injured nerve function before operation improved 1 to 2 grade.

CONCLUSIONThe method of transarticular Hook-screw combination treatment for the unstable Hangman's fracture can obtain effective anatomical reduction and biological stability.