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Mixed Anterior-Posterior Fixation and Fusion for Fully Dislocated Hangman’s Fracture: A Retrospective Evaluation of 11 Circumstances.
Clin Backbone Surg. 2017 Oct;30(eight):E1050-E1054
Authors: Wang J, Chen H, Cao P, Yuan W, Wu X, Liu G, Li R, Zang F, Shi L, Wang A
Summary
STUDY DESIGN: Retrospective scientific research.
PURPOSE: To guage the effectiveness and feasibility of mixed anterior-posterior fixation and fusion for the therapy of utterly dislocated hangman’s fracture.
SUMMARY OF BACKGROUND DATA: A very dislocated hangman’s fracture describes the entire anterior displacement of the C2 vertebral physique onto the C3 physique. Any such fracture is exceptionally unstable, and for which the administration is difficult. Particular therapy methods should be additional clarified.
METHODS: From January 2003 to January 2012, 11 sufferers with utterly dislocated hangman’s fracture underwent mixed anterior-posterior fixation and fusion at our establishment; an anterior-posterior method was utilized in 9 sufferers, and an anterior-posterior-anterior method was utilized in 2 sufferers. The operative time, hospital period, neurological enchancment, fusion fee, and issues had been assessed.
RESULTS: The operation instances of the two anterior-posterior-anterior surgical procedures (165 and 210 min) had been longer than the anterior-posterior method surgical procedures (imply, 133 min; vary: 110-155 min). The typical hospital period was eight.5 days (vary: 7.Zero-13.Zero d). Postoperative discount and stable fusion had been achieved in all sufferers. Neurological standing was considerably improved, because the imply Japanese Orthopedic Affiliation (JOA) rating considerably elevated from a preoperative rating of eight.9±1.7 to 14.6±1.6 on the closing follow-up (P<Zero.01). The imply neurological restoration fee was 51%. Reasonable postoperative neck ache occurred in 2 sufferers, which was relieved after 2 months of conservative therapy with oral celecoxib. The imply visible analog scale ache rating was 1.four±Zero.eight on the final evaluation. Hoarseness was discovered after surgical procedure in 1 affected person who recovered 1 month later with none therapy. No graft-related or plate-related issues occurred throughout all the follow-up interval.
CONCLUSIONS: Mixed anterior-posterior fixation and fusion is an efficient and protected therapy for utterly dislocated hangman’s fracture.
PMID: 28937463 [PubMed – indexed for MEDLINE]