Barker E G, Krumpelman J, Long J M
AJR Am J Roentgenol. 1976 May;126(5):1053-8. doi: 10.2214/ajr.126.5.1053.
Four cases of fracture of the medial aspect of the lateral mass of the atlas are presented. Unlike most cases of atlantal fracture, definite history of a blow to the vertex could not be established. While the exact mechanism of injury is unknown, it is postulated that the bone fragment is produced by a combination of stretching the ligamentum transversarium and pressure on the lateral mass due to contraction of the neck muscles. All four patients were neurologically intact and complained of pain in the distribution of the greater occipital nerve. It is suggested that this fracture might be identified more often in patients with similar histories and complaints by use of laminagraphy, since part or all of the atlas is frequently obscured on routine open mouth roentgenograms of the upper cervical spine.
本文报告了4例寰椎侧块内侧骨折的病例。与大多数寰椎骨折病例不同，无法确定有明确的头顶受击史。虽然确切的损伤机制尚不清楚，但据推测，骨碎片是由横韧带拉伸和颈部肌肉收缩对侧块施加压力共同作用产生的。所有4例患者神经功能均正常，均主诉枕大神经分布区域疼痛。建议对于有类似病史和主诉的患者，使用断层摄影术可能更常发现这种骨折，因为在颈椎上段的常规张口位X线片上，寰椎的部分或全部常常被遮挡。
