1.Halo-vest reduction combined with anterior decompression and internal fixation for lower cervical spine fracture and dislocation
Guanfeng YAO ; Xinjia WANG ; Weidong WANG ; Ruiwu ZHENG ; Lingzi CHEN
Chinese Journal of Trauma 2015;31(8):695-698
Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P < 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.
2.Combined therapy of implants internal fixation and Halo-vest external fixation for the treatment of subaxial cervical fracture-dislocation
Guanfeng YAO ; Xinjia WANG ; Bin LUO ; Weidong WANG ; Jican ZENG
Chinese Journal of Tissue Engineering Research 2013;(35):6351-6356
BACKGROUND:There is controversial in choosing the treatment method for the treatment of traumatic subaxial cervical fracture-dislocation and spinal cord injury.
OBJECTIVE:To evaluate the clinical effect of implant internal fixation and Halo-vest external fixation on the stability after treatment of subaxial cervical fracture-dislocation.
METHODS:A retrospective analysis was conducted on 17 patients with subaxial cervical fracture-dislocation in the Department of Orthopedics, the Second Affiliated Hospital of Shantou University Medical Col ege between January 2009 to December 2011, including 13 male patients and 4 female patients, the age was ranged from 21-65 years, average 41.6 years. There were six cases of high fal ing injury, three cases of crush injury and eight cases of traffic accident injury. The hospitalization time after injury was 2 hours to 5 days, average 2.5 days. Al the patients received Halo-vest external fixation under local anesthesia, then distraction gradual y, and received anterior decompression graft and titanium screw fixation under reduction. The treatment effect was evaluated
through Frankel classification and imaging examination.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-24 months, average 15.4 months. Normal anteraposterior X-ray film showed fracture reduction, the cervical vertebra restored to the normal
sequence and physiological curvature;CT showed graft fusion without internal fixation fracture and loosing;
according to Frankel classification, marked effect (decreased for 2 grade) in five cases, effective (decreased for 1
grade) in 10 cases, and ineffective in two cases. Implant internal fixation combined with Halo-vest external fixation is safe and reliable in the instability fixation of subaxial cervical fracture-dislocation, and can better restore the spinal sagittal alignment.
3.Study of surgical style of treating acute mesenteric venous thrombosis
Guanfeng YU ; Jiangao YAO ; Jun CHENG ; Yunfeng HONG ; Yuming WANG ; Qiyu ZHANG ; Hongqi SHI ; Xiaolei CHEN ; Xiaofeng DENG
Chinese Journal of Practical Surgery 2001;21(3):154-155
Objective To explore the best therapeutic methods for acute mesenteric venous thromboses(AMVT)with different degrees of intestinal ischemic lesions. Methods 6 cases of acute abdomen were preoperatively diagnosed as AMVT with imaging. After laparotomy, patients were classified as congestive lesion(n=3)and necrotic lesion(n=3)according to the degree of intestinal sichemia and were treated with mesenteric thrombectomy and bowel resection, respeetively. All cases received heparin and urokinase perioperatively. Results Of the 3 patients receiving mesenteric thrombectomy, 2 were cured and the other one with ischemic ascending colon was cured after right hemicolectomy due to the complication of colic dynamic ileus and perforation 10 days after thrombectomy. The other 3 patients recovered after bowel resection. Follow-up from 8 months to 6 years showed no recurrence. Conclusion Combined with anti-coagulation therapy, thrombectomy and bowel resection are rational and effective protocol for congestive lesion and necrotic lesion, respectively in AMVT patients.