Hallak Bassel, Von Wihl Sonia, Boselie Franciscus, Bouayed Salim
Department of Otorhinolaryngology, Hospital of Sion, Sion, Switzerland.
BMJ Case Rep. 2018 Dec 7;11(1):e226677. doi: 10.1136/bcr-2018-226677.
Acute laryngeal trauma is estimated to occur in approximately one patient per 14 500 to 42 500 emergency room admissions. If the larynx is injured, its vital functions are affected and can be threatened in case of severe injury. Soft cartilage offers no protective advantage, which is the reason why young as well as older individuals are at risk of thyroid cartilage fracture. Experimentation on cadaver larynx has demonstrated that virtually all laryngeal fractures are longitudinally oriented. Furthermore, muscular pull can contribute to a misalignment of the fractures. As stated by Bent and Porubsky, a fracture is considered severely rather than moderately displaced, if it is freely mobile on physical examination, has more than two fracture lines or demonstrates a displacement greater than the width of the thyroid cartilage on CT imaging. We present two cases of severely displaced thyroid cartilage fracture treated in our department by open reduction and internal fixation using miniplates. Functional and radiological outcomes were excellent.
据估计,在每14500至42500例急诊室入院患者中,约有1例发生急性喉外伤。如果喉部受伤,其重要功能会受到影响,严重受伤时可能会受到威胁。软骨较软并无保护优势,这就是年轻人和老年人都有甲状软骨骨折风险的原因。对尸体喉部进行的实验表明,几乎所有喉部骨折都是纵向的。此外,肌肉牵拉会导致骨折错位。正如本特(Bent)和波鲁布斯基(Porubsky)所述,如果骨折在体格检查时可自由移动、有两条以上骨折线或在CT成像上显示移位大于甲状软骨宽度,则认为骨折为严重移位而非中度移位。我们介绍两例在我科采用微型钢板切开复位内固定治疗的严重移位甲状软骨骨折病例。功能和影像学结果均极佳。