齿突骨折与迟发性寰枢椎脱位.ppt

齿突骨折与迟发性寰枢椎脱位
Preface
Dens axis
Atlantoaxial stability
Most important axial bone structure
Odontoid fracture
Atlantoaxial instability
Secondary SCI
Odontoid fracture
7~10% of cervical spine fracture
cause SCI instantly
Respiratory dysfunction
Even death
Special structures and function
High ununion rate after fracture
Odontoid fracture
Lack of effective treatment
Not treated
Unstable factors exist
Atlas lost the restriction
of Dens axis and ligaments
Delayed atlantoaxial dislocation
Clinical information
Male 41 cases Female 15 cases
Age range 15~58 yrs Average yrs
11~20 yrs 5 cases 21~31yrs 16 cases
31~ 40yrs 23 cases 41~50yrs 7 cases
50~58yrs 5 cases
Injury causes
Accidental falls 15 cases
building work accident 12 cases
drop from bed 3 cases
Motor vehicle accident 11 cases
Sports-related injury 13 cases
water dive 7 cases
Tumble on ground 7 cases
Weight hurt 10 cases
Course of diseases
Time from injury to treatment
shortest 4 weeks longest 26 months
1~3M 23 cases 4 ~ 6M 15 cases
7~9M 11 cases 10~12M 4 cases
>1 yrs 3 cases
Treatment course
not treated after injury 12 cases
no diagnosis when admitted 7 cases
skull traction 2~3W
stabilized by collars 16 cases
only collars stabilization 21 cases
Local features
Uncomfortable and pain of neck and nape 37 cases
Middle or bilateral area of the occipitocervical
Possible feeling of hyperesthesia or pain at fields
dominated by great occipital or great auricular nerve
Skull and neck motor limitation 21 cases
Tilt stiffness of head and neck 14 cases
Motor function
Normal gait, no motor limitation
work properly 16 cases
Weakness of legs, clumsy action, but can walk
weakness of hands
grasping function not affected