O'Brien J J, Butterfield W L, Gossling H R
Clin Orthop Relat Res. 1977 Jul-Aug(126):135-8.
A 20-year-old male incurred a vertex injury of the skull, disruption of the transverse ligament of the atlas, and a Jefferson fracture--lateral displacement of the lateral masses of the atlas in relation to the lateral margins of the second cervical vertebra. The combination of Jefferson fracture with transverse ligament disruption was not appreciated initially (or even late) because of the head injury. The hospital course was complicated by the patient's initial unconsciousness and restlessness caused by associated intracranial injury. Roentgenograms in all views of the cervical spine were essential to its recognition and had to be carefully examined. Laminograms of the cervical spine showed a small anterolateral fragment on the right at the location of the tubercle attachment of the transverse ligament. Surgical stabilization is essential in this complex injury to protect the spinal cord from damage by subluxation and/or dislocation at the C1-C2 interval. Posterior cervical fusion of C1-C2 was performed at 4 1/2 weeks postinjury to allow time for healing of the ring of the atlas.
一名20岁男性颅骨顶部受伤，寰椎横韧带断裂，伴有Jefferson骨折——寰椎侧块相对于第二颈椎侧缘向外移位。由于头部受伤，最初（甚至后期）未认识到Jefferson骨折合并横韧带断裂的情况。患者因伴有颅内损伤而最初意识不清、烦躁不安，使住院过程复杂化。颈椎的所有视图的X线片对其诊断至关重要，必须仔细检查。颈椎体层摄影显示在横韧带结节附着处右侧有一个小的前外侧碎片。对于这种复杂损伤，手术稳定至关重要，以保护脊髓免受C1-C2间隙半脱位和/或脱位的损伤。受伤后4.5周进行了C1-C2后路颈椎融合术，以便有时间让寰椎环愈合。
