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使用可吸收缝线对2岁儿童Ⅱ型齿状突骨折进行C1-C2后路固定:一种新技术的描述及文献综述

Posterior C1-C2 Fixation Using Absorbable Suture for Type II Odontoid Fracture in 2-Year-Old Child: Description of a New Technique and Literature Review.

作者信息

Labbe Jean L, Peres Olivier, Leclair Olivier, Goulon Renaud, Scemama Patrice, Jourdel François, Bertrou Véronique, Murgier Jerome

机构信息

*Orthopedic and Traumatologic Surgery Department †Anesthesia Department, Nouméa Territorial Hospital, Nouméa, New Caledonia ‡Pierre Paul Riquet Hospital, Orthopedics and Trauma Surgery, Musculoskeletal Institute, Toulouse, France.

出版信息

J Pediatr Orthop. 2016 Dec;36(8):e96-e100. doi: 10.1097/BPO.0000000000000637.

Abstract

UNLABELLED

Odontoid synchondrosis fractures are rare in children, even though they are the more common cervical fracture in children less than 7 years old. Nonoperative treatment with external orthosis immobilization is the treatment of choice for stable undisplaced or minimally displaced injuries. In unstable fractures, when reduction cannot be achieved or maintained, surgical fixation is recommended. We report a 2-year-old boy with an unstable fracture of the odontoid treated surgically using an absorbable monofilament suture for C1-C2 interlaminar fixation without bone grafting. This suture was strong enough to provide the stability necessary to allow healing of the synchondrosis and the delayed resorption of the suture was followed by complete restoration of the mobility between C1 and C2. This case illustrates that surgical stabilization using an absorbable suture in young children with an unstable odontoid fracture is a safe and effective alternative to other surgical techniques.

LEVEL OF EVIDENCE

Level III.

摘要

未标注

齿突软骨结合部骨折在儿童中较为罕见,尽管它是7岁以下儿童中较常见的颈椎骨折。对于稳定的无移位或轻度移位损伤,采用外部矫形器固定进行非手术治疗是首选治疗方法。在不稳定骨折中,当无法实现或维持复位时,建议进行手术固定。我们报告了一名2岁男孩,其齿突骨折不稳定,采用可吸收单丝缝线进行C1 - C2层间固定,无需植骨,手术治疗。这种缝线足够坚固,能够提供必要的稳定性,使软骨结合部得以愈合,缝线延迟吸收后,C1和C2之间的活动度完全恢复。该病例表明,对于幼儿不稳定齿突骨折,使用可吸收缝线进行手术稳定是一种安全有效的替代其他手术技术的方法。

证据级别

三级。

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