Hangman Fracture Selective Treatment

Obsjecctive : Retrospective studies of Hangman's fracture cases with cervical spinal cord injury were carried out to find out the patient's myeloid functional recovery before and after different treatment, and determine the trearment strategy and clinical results of surgical management of Hangman's fracture.Methods: Among 42 cases of Hangman's fracture,31 Hangman's fracture cases with cervical spinal cord injury were retrospective analyzed .they all were followed up and their clinical data were complete. The mechanisms of injury were traffic accident in 16 cases, bruise in 5 cases,falling down in 8 cases other cause in 2 cases. 12 cases received non-operative treatment. there were 11 males and 1 females, aging from 22 to 62 with an average of 34.4 years.According to a Levine and Edwards System,there were 1 cases ofⅠType Hangman's fracture, 4 TypeⅡHangman's fracture,5 TypeⅡa Hangman's fracture and 2 TypeⅢHangman's fracture.10 cases received anterior fusion and internal fixation with anterior plate.there were 9 males and 1 females, aging from 18 to 50 with an average of 33.6 years.According to a Levine and Edwards System,there were 3 cases ofⅡType Hangman's fracture,5 TypeⅡa Hangman's fracture and 2 TypeⅢHangman's fracture.9 cases received posterior pedicle screws fixation.there were 8 males and 1 females, aging from 22 to 51 with an average of 30.8 years.According to a Levine and Edwards System,there were 3 cases ofⅡType Hangman's fracture,4 TypeⅡa Hangman's fracture and 2 TypeⅢHangman's fracture.General treatments are performed to the in-patients firstly, being dehydrated and applied with standard hormone strategy. Varied traction directions and forces, cervical locations were designed according to different injury causes, fracture pattern. In non-operative cases, traction forces began at 2Kg normally. 6 weeks later Halo-vest frames were adapted till bony fusion achieved. The anterior operation cases underwent skull traction for close reduction and a anterior approach was choosen to exposure cervical vertebrac 2.3(C2.3).Anterior fusion and plate fixation were carried out following anterior discectomy and decompression of C2,3. The posterior operation patients were laid in prostrate decubitus with skull traction in place to maintain reduction ,a posterior midline incision from C1-C3 was performed ,and soft tissue was released to expose clearly, and usually 25°-30°...