Tanaka Yuki, Watanabe Kei, Katsumi Keiichi, Ohashi Masayuki, Nagasaki Keisuke, Hirano Toru
Departments of Orthopedic Surgery (Y.T., K.W., K.K., M.O., and T.H.) and Pediatrics (K.N.), Niigata University Medical and Dental General Hospital, Niigata City, Niigata, Japan.
JBJS Case Connect. 2017 Jan-Mar;7(1):e16. doi: 10.2106/JBJS.CC.16.00121.
We present a case of brachytelephalangic chondrodysplasia punctata with a severe atlantoaxial dislocation in an underdeveloped child. The patient underwent halo jacket application using 10 halo pins with <1 lb/in of torque, followed by posterior occipitocervical fusion with onlay rib and iliac autografts. After bone grafts and replacement of the halo ring multiple times, successful osseous fusion had been achieved by the 2-year follow-up.
Although simple bone-grafting with a halo jacket is useful in underdeveloped patients with skeletal dysplasia, the complications related to halo fixation, including cranial bone perforation, and the patient's neurological status must be carefully monitored.
我们报告一例发育不全儿童的短指（趾）型点状软骨发育不良合并严重寰枢椎脱位。患者使用10枚头环针，以<1磅/英寸的扭矩进行头环背心固定，随后采用肋骨和髂骨自体骨块进行枕颈后路融合术。多次植骨并更换头环后，至随访2年时成功实现了骨性融合。
虽然对头环背心进行单纯植骨对骨骼发育不全的患者有用，但必须仔细监测与头环固定相关的并发症，包括颅骨穿孔，以及患者的神经状态。
