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Administration of mixed atlas-axis fractures: a evaluate of forty one instances.
Int Orthop. 2016 Jun;40(6):1179-86
Authors: Lin B, Wu J, Chen ZD, Zeng W, Liu Q, Dai L
Summary
PURPOSE: To stipulate a administration precept for the mixed atlas (C1)-axis (C2) fractures and assess its therapeutic results.
METHODS: Forty-one sufferers with mixed C1-C2 fractures have been handled in accordance with their C2 fracture sorts. Non-operative exterior immobilization within the type of a cervical collar or halo vest was utilized in 22 sufferers. Early posterior pedicle screw fixations have been carried out in 19 sufferers whose fractures had a mix of any of the three situations: an atlantodens interval (ADI)???5 mm, lateral mass displacement (LMD)?>?7 mm, and/or C2-C3 angulation?>?11°. Thirty-nine sufferers have been adopted up often with a median of 19.three months (vary, 12 to 45 months). Medical and radiographic information have been then collected and in contrast.
RESULTS: At three months following therapy, sufferers’ visible analog scale (VAS), Neck Incapacity Index (NDI), American Spinal Harm Affiliation (ASIA) scale, and Frankel grades have been all considerably improved when in comparison with pretreatment. These outcomes indicated that the cervical collar, halo vest, and posterior pedicle screw fixation approaches have been all capable of successfully deal with instances of mixed C1-C2 fractures. One affected person within the non-surgical group developed nonunion which required late surgical therapy and one affected person had pin web site an infection within the non-surgical group (2/22), whereas there have been three minor problems within the surgical group.
CONCLUSION: We suggest a administration precept that bases the therapy of a mixed C1-C2 fracture on the character of the C2 fracture. This therapy technique has yielded promising outcomes as a passable means for the administration of mixed C1-C2 fractures.
PMID: 26686497 [PubMed – indexed for MEDLINE]