| 摘要 |
While odontoid fractures are common injuries, disagreement exists regar-ding treatment. Some authors claim a high percentage of nonunion after various conservative treatment methods and have therefore recommended early posterior fixation and fusion. This, however, can result in significant limitation of head and neck rotation by approximately 47*. Therefore, it has been recommended that a more direct approach to the treatment of this type of fracture be taken. Seventeen cases of odontoid fracture treated by the author with anterior screw fixation between October 1991 and August 1995 were included in the present study, 14 of them from traffic accidents, 3 from accidental falls. The modality of bone union and patient's outcome were evaluated. Sixteen cases had Anderson D'Alonzo Type II frac- tures and the remaining case had a shallow Type III fracture. In 10 of these cases the fracture was fixed with one screw and in 7 it was fixed with two screws. Good union was achieved in 15 cases, but one case showed nonunion and another one pseudoarthrosis. The follow-up period was from 30 to 76 months, with a mean of 51 months. Odontoid screw fixation is a technically demanding procedure that can be used in the treatment of odontoid frac- tures. This method did not diminish post-treatment cervical motion as it
did not require an arthrodesis, and most patients needed only a minimal
amount of postoperative external immobilization. |
