Fowler J L, Sandhu A, Fraser R D
Royal Cornwall Hospital (City), Infirmary Hill, Truro, U.K.
J Spinal Disord. 1990 Mar;3(1):19-24.
From 48 consecutive cases of atlas fractures presenting over a 12.5-year period, two groups are apparent that differ in age, presentation, mechanism of injury, and treatment given. Jefferson fractures were, on average, 42 years of age. Displaced Jefferson fractures were treated by traction. At final review, those that had been reduced and those that were initially undisplaced did better than the displaced group. Inadequate reduction was often obtained due to insufficient traction. Patients sustaining a posterior arch fracture were generally more elderly and were, on average, 17 years older than those with a Jefferson fracture. Patients with a posterior arch fracture had marked degenerative changes in the mid- to distal cervical spine and almost invariably had another cervical spine fracture. Treatment was usually directed to the other cervical spine injury. Injury in the elderly usually followed low velocity trauma.
在12.5年期间出现的连续48例寰椎骨折病例中，明显可分为两组，这两组在年龄、临床表现、损伤机制和治疗方式上存在差异。Jefferson骨折患者的平均年龄为42岁。移位的Jefferson骨折采用牵引治疗。在最后复查时，骨折已复位的患者和最初未移位的患者比移位组的情况更好。由于牵引不足，常常无法实现充分复位。发生后弓骨折的患者通常年龄更大，平均比Jefferson骨折患者大17岁。后弓骨折患者在颈椎中下段有明显的退行性改变，几乎都伴有另一处颈椎骨折。治疗通常针对其他颈椎损伤。老年人的损伤通常由低速创伤所致。
