Spoor Andy B, Diekerhof Carel H, Bonnet Michel, Oner F Cumhur
St Elisabeth Hospital Tilburg, Department of Orthopedic Surgery, Hilvarenbeekseweg, GC Tilburg.
Spine (Phila Pa 1976). 2008 Sep 1;33(19):E708-11. doi: 10.1097/BRS.0b013e31817c140d.
Case report and clinical discussion.
We intend to report a unique case of a atlantoaxial dislocation with a odontoid and C2 superior articular facet fracture.
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.
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.
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.
To our knowledge, this is the first case of a traumatic atlantoaxial rotatory dislocation with accompanying odontoid and C2 superior articular facet fracture.
病例报告及临床讨论。
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。
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。
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。
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。
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。