Transoral screw and wire fixation for unstable anterior ½ atlas fracture
| Autor: | Semih Keskil, Murat Göksel, Ulaş Yüksel |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Lamina
lcsh:Diseases of the musculoskeletal system wire Good reduction C1 fracture 03 medical and health sciences Fixation (surgical) 0302 clinical medicine Atlas (anatomy) Atlas fracture medicine screw Wire fixation Fracture type Orthodontics 030222 orthopedics Osteosynthesis business.industry medicine.anatomical_structure Surgery Original Article Neurology (clinical) lcsh:RC925-935 transoral Range of motion business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Craniovertebral Junction & Spine Journal of Craniovertebral Junction and Spine, Vol 8, Iss 4, Pp 364-368 (2017) |
| ISSN: | 0974-8237 |
| Popis: | Study Design: Atlas fractures are evaluated according to the fracture type and ligamentous injury. External immobilization may result in fracture nonunion. Objective: The ideal treatment method for non-stabilized atlas fractures is limited fixation without restricting the range of motion of the atlantoaxial and atlantooccipital joints. Summary of Background Data: Such a result can be established by using either anterior fixation or posterior lateral mass fixation. However, none of these techniques can fully address anterior 1/2 atlas fractures such as in this case. Materials and Methods: A transoral technique in which bilateral screws were placed intralaminarly and connected with wire was used to reduce and stabilize an anterior 1/2 fracture of C1. Result: Radiological studies after the surgery showed good cervical alignment, no screw or wire failure and good reduction with fusion of anterior arcus of C1. Conclusions: Internal immobilization by this screw and wire osteosynthesis technique protects the mobility of the atlanto-occipital and atlantoaxial joints. The main advantage is that neither the twisted wires inserted under the anterior lamina, nor the laterally placed screw heads interfere with midline wound closure; unlike the plate/cage and rod systems used together with anterior screws. A computer navigation system with intraoperative 3D imaging facilities will be of benefit for safe placement of the screw, however we preferred a free-hand technique, as the starting point was at the fracture line along the trajectory of the routinely accessible anterior lamina. |
| Databáze: | OpenAIRE |
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