Percutaneous triple anterior screw fixation of acute combined atlas-axis fractures in elderly patients:a primary report
10.3760/cma.j.issn.0253-2352.2011.10.011
- VernacularTitle:前路经皮三钉固定治疗老年寰枢椎联合骨折
- Author:
Xiangyang WANG
- Publication Type:Journal Article
- Keywords:
Atlas;
Axis;
Spinal fractures;
Fracture fixation,internal;
Surgical procedures,minimally invasive;
Aged
- From:
Chinese Journal of Orthopaedics
2011;31(10):1056-1060
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the clinical effect of the percutaneous fixation for atlas-axis combined fractures in the elderly patients,especially with brain injury.MethodsFrom March 2006 to February 2011,a total of 7 cases with C1,2 combined fractures entered the study,including 5 males and 1 female with an average age of 72.4 years (range,64-84 years).Fracture combinations included two Jefferson/type Ⅱ odontoid,two anterior ring/type Ⅱ odontoid,two anterior and posterior ring/type Ⅱ odontoid,and one anterior and posterior ring+lateral mass/type Ⅲ odontoid.There were 5 patients with head injuries in varying degrees of coma.All patients underwent percutaneous placement of odontoid screw and anterior C1,2 transarticular screws (triple anterior screw fixation),and were immobilized in a hard collar for 3 months postoperatively.Results The average duration of the operation was 56 min(range,36-78 min).Satisfactory results were achieved in all patients,and all screws were in good position.There were no intraoperative surgery-related complications.The mean follow-up period was 10.7 months.During the follow-up,no pullout,loosening,distortion,or breakage of internal screws was observed.Radiographic union occurred in all odontoid fractures and C1,2 stable was found in all case.ConclusionFor elderly patients especially those with brain injury,the triple anterior screw fixation is reliable and effective in dealing with combined atlas-axis fractures.This percutaneous surgery has the advantages of less invasive,less blood loss,less pain and early recovery.
