Tian Ji-wei, Wang Zhen, Wang Lei, Dong Shuang-hai, Zhao Qing-hua, Xia Tian
Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated First Peoples' Hospital, Shanghai 201620, China.
Zhonghua Yi Xue Za Zhi. 2009 Dec 22;89(47):3363-5.
To evaluate the therapies and clinical outcome for different types of odontoid process fracture.
Twenty-one patients with odontoid process fracture were treated with different therapies for different Anderson-D'Alonzo classifications: three cases of type I were treated by traction of occipital-jaw band and fixed with head-neck-chest plaster at 6 weeks; thirteen cases of type II were treated by cannulated screws following skull traction and reduction; and for the cases of type III, one was fixed with screw when the fracture was reduced by skull traction, and four with atlantoaxial pedicle screw.
All cases were followed up for a mean of 9 months (range: 3 - 48). All cases achieved bony union. No post-operative complication was found.
Odontoid process fracture should be treated according to different types. Conservative treatment for type I fracture and cannulated screws for type II and low type III fracture can obtain a satisfactory outcome. Atlantoaxial pedicle screw should be chosen if the superficial type III fracture is not suitable for cannulated screw.
评估不同类型齿状突骨折的治疗方法及临床疗效。
对21例齿状突骨折患者根据不同的Anderson-D'Alonzo分型采用不同治疗方法：Ⅰ型3例，采用枕颌带牵引，6周时用头颈胸石膏固定；Ⅱ型13例，颅骨牵引复位后采用空心螺钉治疗；Ⅲ型中，1例颅骨牵引复位后用螺钉固定，4例采用寰枢椎椎弓根螺钉固定。
所有病例平均随访9个月（范围：3 - 48个月）。所有病例均获得骨性愈合。未发现术后并发症。
齿状突骨折应根据不同类型进行治疗。Ⅰ型骨折采用保守治疗，Ⅱ型和低位Ⅲ型骨折采用空心螺钉治疗可获得满意疗效。对于浅表Ⅲ型骨折若不适合空心螺钉治疗，应选用寰枢椎椎弓根螺钉。
