Neglected hangman fracture.
| Autor: | Srivastava SK; Department of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Parel, Mumbai, Maharashtra, India., Aggarwal RA; Department of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Parel, Mumbai, Maharashtra, India., Nemade PS; Department of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Parel, Mumbai, Maharashtra, India., Bhoale SK; Department of Orthopaedics, Seth G.S. Medical College and K.E.M Hospital, Parel, Mumbai, Maharashtra, India. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of craniovertebral junction & spine [J Craniovertebr Junction Spine] 2015 Oct-Dec; Vol. 6 (4), pp. 209-11. |
| DOI: | 10.4103/0974-8237.167884 |
| Abstrakt: | Acute management of hangman fracture is well described; however the surgical management of neglected hangman fracture has not been described in literature. We report the surgical management of an untreated hangman's fracture. A 30-year-old male had fallen from a tree 12 weeks back. Patient presented with cervical myelopathy and restricted neck movements. Radiographs and computed tomography (CT) scan revealed fracture of pars interarticularis of axis with Grade III C2-C3 spondylolisthesis with localized kyphosis of 33°. Gentle reduction under general anesthesia (GA) failed to improve the alignment. Patient was operated in three stages in a single setting. In Stage I, release of contracted anterior structures and C2-C3 discectomy was done in supine position followed by C2-C3 posterior fixation and fusion in Stage II. C2-C3 interbody bone grafting and anterior plating completed the third stage. C2-C3 interbody fusion was seen at 5 months and a CT scan at 18 months postoperative confirmed fusion and maintenance of alignment. The satisfactory outcome in our patient leads us to believe that anterior-posterior-anterior is the appropriate surgical approach for treatment of such patients. |
| Databáze: | MEDLINE |
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