不同类型齿状突骨折治疗方法的比较.docVIP

不同类型齿状突骨折治疗方法的比较 　　[摘要] 目的 研究并评价不同类型齿状突骨折患者所使用的治疗方法及临床治疗效果。 方法 择取2011年12月～2016年12月期间于我院治疗齿状突骨折的90例患者，按照不同分型将其分为三组，各组均30例。Ⅰ型患者行枕颌带牵引并在6周后以石膏固定头颈胸；Ⅱ型患者行颅骨牵引复位，于齿状突使用螺钉进行中孔固定；Ⅲ型患者行颅骨牵引复位，螺钉中空固定齿状突或在颈后路寰枢椎使用椎弓根螺钉进行固定。比较三组患者的临床治疗效果、并发症发生率以及术前术后影像学表现。 结果 就治疗效果而言，Ⅰ组总有效率为96.67%（29/30），Ⅱ组为100.00%（30/30），Ⅲ组为93.33%（28/30）。Ⅰ组并发症发生率为3.33%（1/30），Ⅱ组为10.00%（3/30），Ⅲ组为6.67%（2/30）。结论 齿状突骨折的类型不同，方法也有所不同，临床应根据患者的骨折类型、严重程度选择适宜的方法，不可过度治疗。 　　[关键词] 齿状突骨折；不同类型；内固定；牵引复位 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2017）18-0077-03 　　Comparison of the treatment methods of different types of odontoid fractures 　　WANG Guanglin SU Xiaohua 　　No.2 Department of Orthopedics， Xinwen Mining Group Laiwu Central Hospital， Laiwu 271103， China 　　[Abstract] Objective To explore and evaluate the treatment methods and curative effects of different types of odontoid fractures. Methods 90 patients with odontoid fractures who were treated in our hospital from December 2011 to December 2016 were selected. The patients were divided into three groups according to different types， with 30 cases in each group. For type Ⅰ patients， occipital-jaw traction was given and plaster fixation of head and neck was given after six weeks； for type Ⅱ patients， skull traction reduction was given， and mesopore fixation was given by screws in odontoid； for type Ⅲ patients， skull traction reduction was given， and screw hollow fixation of the odontoid or pedicle screw fixation was given in posterior cervical atlantoaxial joint. The clinical curative effect， the incidence rate of complications and preoperative and postoperative imaging findings were explored in the three groups of patients. Results In terms of the curative effects， the total curative rate was 96.67%（29/30） in group Ⅰ， 100.00%（30/30） in group Ⅱ and 93.33%（28/30） in group Ⅲ. In terms of the incidence rate of complications， the rate was 3.33%（1/30） in group Ⅰ， 10.00%（3/30） in group Ⅱ and 6.67%（2/30） in group Ⅲ. Conclusion The types of odontoid fractures are differe