Treatment choices for atlantoaxial complex fractures / 中华创伤杂志

ABSTRACT

Objective To discuss the clinical characteristics,injury mechanisms,and treatment options of atlantoaxial complex fractures.Methods Twenty-three patients with atlantoaxial complex fractures were enrolled in the study,including 13 men and 10 women with age ranging from 23 to 63 years (average 42.6 years).Treatment options were determined on the basis of injury patterns of the patients,including nonoperative treatments for 11 patients and operative treatments for 12 patients.Complications and prognosis were evaluated for all patients in follow-up.Results All patients were followed up for average 32 months (range,6-58 months),which showed the recovery of atlantoaxial stability and the bony union or fusion.At postoperative six months,Japanese Orthopedics Association (JOA) score of all patients averaged 14.1 points (range,11.5-15.8 points) with the improvement rate of 82.7％.No complications like spinal cord injury,vertebral artery injury or cerebrospinal fluid leakage occurred in operative treatment group.Conclusions Mechanisms of atlantoaxial complex fractures are largely overextension/compression and lateral bending/compression.Furthermore,treatment plans should be determined in the light of fracture types.