摘要 Hangman骨折又称为创伤性枢椎滑脱,指在暴力作用下枢椎上下关节突峡部之间的骨折,往往伴随着椎间盘及韧带的损伤,从而引起C2~3的位移和成角畸形。造成Hangman骨折最常见的原因是交通事故或高处坠落伤,是除齿状突骨折之外最常见的枢椎骨折类型,占颈椎骨折的4%~7%,占枢椎骨折的20%~22%。Ⅰ型为稳定型骨折,一般认为保守治疗即可。Ⅱ型、Ⅱa型、Ⅲ型为不稳定型骨折,保守治疗效果差,需要采取手术方式加以矫正。常用手术方式包括:颈前路椎间盘切除减压融合术(anterior cervical decompression and fusion,ACDF)、C2椎弓根钉内固定术、C2椎弓根联合C3椎弓根(侧块)螺钉内固定术、C1~3侧块螺钉内固定术及前后路联合手术等,这些手术方式均具有良好的愈合率和临床效果。但对于Ⅲ型Hangman骨折,其手术方式的选择仍然具有争议,尚未达成共识。近年来,随着技术的发展和研究的深入,Ⅲ型Hangman骨折的手术治疗方式有了更多的评价标准。
通讯作者:
马迅
作者简介 : 徐昊(1995- ),男,研究生在读,山西白求恩医院骨科,xuhao19952021@163.com
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