采用头环装置治疗创伤性寰枢椎旋转性脱位和移位性终末小骨骨骺分离：1例报告
Traumatic atlantoaxial rotatory dislocation and displaced ossiculum terminale epiphysiolysis treated with a halo device: a case report.
作者信息
Walbom Jonas, Kruse Anders
机构信息
Center for Rheumatology and Spine Diseases, Rigshospitalet-Glostrup, Copenhagen University Hospital, Nordre Ringvej 57, 2600, Glostrup, Denmark.
Department of Orthopaedic Surgery, Spine Unit, Rigshospitalet-Blegdamsvej, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
出版信息
Childs Nerv Syst. 2016 Jul;32(7):1321-5. doi: 10.1007/s00381-016-3025-2. Epub 2016 Jan 29.
INTRODUCTION
The horizontal synchondroses of the infant axis are biomechanical weak regions in trauma.
CASE
We report the case of a 6-year-old girl who presented with delayed atlantoaxial dislocation and displaced ossiculum terminale epiphysiolysis after a fall from a tree.
TREATMENT
The patient was treated with halo traction for 3 days after which a CT scan showed normal position of the C1/C2 joint, and an acceptable position of the ossiculum terminale whereafter a halo brace was applied. Because of delayed union on CT scans, the treatment was prolonged to a total of 21 weeks.
RESULT
At final follow-up 26 months after halo brace removal, the patient demonstrated normal range of movement of the neck on clinical examination and radiographs of the cervical spine including lateral flexion/extension radiographs showed no sign of instability of the atlantoaxial joint.
DISCUSSION
Conservative treatment with a halo device versus surgical treatment is discussed.
引言
婴幼儿枢椎的水平软骨结合部在创伤中是生物力学薄弱区域。
病例
我们报告一名6岁女孩的病例，她从树上跌落之后出现了迟发性寰枢椎脱位和终末小骨骨骺分离移位。
治疗
患者接受了3天的头环牵引治疗，之后CT扫描显示C1/C2关节位置正常，终末小骨位置尚可，随后应用了头环支具。由于CT扫描显示愈合延迟，治疗延长至总共21周。
结果
在去除头环支具26个月后的最终随访中，临床检查显示患者颈部活动范围正常，颈椎X线片包括侧屈/伸展位X线片显示寰枢关节无不稳定迹象。
讨论
讨论了头环装置保守治疗与手术治疗的情况。
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