Management and diagnosis of traumatic atlantal fractures complicated with disruption of the transverse atlantal ligament
- VernacularTitle:寰椎Jefferson骨折伴横韧带损伤的诊治
- Author:
Xiang GUO
;
Bin NI
;
Chunsheng TAO
- Publication Type:Journal Article
- Keywords:
Vertebrae;
Spinal fracture;
Ligament injury
- From:
Chinese Journal of Orthopaedic Trauma
2002;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze diagnosis and management of traumatic atlantal fractures complicated with disruption of the transverse atlantal ligament. Methods Twenty-six patients with traumatic atlantal fractures complicated with disruption of the transverse atlantal ligament, 20 acute ones and six old ones, were managed in our department from March 1995 to March 2005. All the patients had the symptom of neck pain and a certain extent of neurological deficits. The radiographic examination showed that there were fractures in the anterior arch or/and lateral mass of the atlas and that the atlanto-dental interval (ADI) in these patients was 4 to 7 mm. Twenty-one cases were operated on with occipitocervical or atlantoaxial fusion immediately after injury. Five cases received conservative treatment. Results All were followed up for 15 (from 6 to 24) months on average. The 21 cases treated operatively reported relieved symptoms. Four of the five conservative treatments succeeded, but one of them underwent a successful atlantoaxial fusion because the original conservative treatment had failed. Conclusions The severity of clinical symptoms mostly depends on the degrees of atlantal displacement and cord compression. Diagnosis should be made on the basis of the ADI change as well as clinical presentations. For patients who have potential risk of atlantoaxial instability, occipitocervical or atlantoaxial,usion should be performed early.
