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伴有齿突及C2上关节面骨折的创伤性寰枢关节复杂脱位

Traumatic complex dislocation of the atlanto-axial joint with odontoid and C2 superior articular facet fracture.

作者信息

Spoor Andy B, Diekerhof Carel H, Bonnet Michel, Oner F Cumhur

机构信息

St Elisabeth Hospital Tilburg, Department of Orthopedic Surgery, Hilvarenbeekseweg, GC Tilburg.

出版信息

Spine (Phila Pa 1976). 2008 Sep 1;33(19):E708-11. doi: 10.1097/BRS.0b013e31817c140d.

Abstract

STUDY DESIGN

Case report and clinical discussion.

OBJECTIVE

We intend to report a unique case of a atlantoaxial dislocation with a odontoid and C2 superior articular facet fracture.

SUMMARY OF BACKGROUND DATA

Traumatic dislocation of the atlantoaxial joint in combination with a C2 fracture is a rare injury. Only 5 cases have been reported in the literature.

METHODS

We present a case of a 43-year-old man with a primary atlantoaxial complex dislocation associated with an odontoid and comminuted C2 superior articular facet fracture with complete recovery of an accompanying hemiplegia after reduction.

RESULTS

The patient underwent gentle traction with a halo frame until a complete reduction was achieved within 3 days, after which a vest was installed. His neurologic status improved to a slight weakness of the right shoulder in abduction (Grade 4/5) after 4 months and his C2 fracture healed in an acceptable position.

CONCLUSION

To our knowledge, this is the first case of a traumatic atlantoaxial rotatory dislocation with accompanying odontoid and C2 superior articular facet fracture.

摘要

研究设计

病例报告及临床讨论。

目的

我们打算报告一例寰枢椎脱位合并齿突及C2上关节面骨折的独特病例。

背景资料总结

寰枢关节创伤性脱位合并C2骨折是一种罕见损伤。文献中仅报道过5例。

方法

我们报告一例43岁男性患者,其原发性寰枢复合体脱位合并齿突及C2上关节面粉碎性骨折,复位后伴随的偏瘫完全恢复。

结果

患者使用头环支架进行轻柔牵引,直至3天内完全复位,之后安装背心。4个月后,其神经功能状态改善为右肩外展轻度无力(4/5级),C2骨折在可接受位置愈合。

结论

据我们所知,这是首例伴有齿突及C2上关节面骨折的创伤性寰枢椎旋转脱位病例。

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