Anterior Hollow Tension Screw Fixation For Odontoid Fracture

Objective:Assessment application through anterior portion road hollow tension screw internal fixation technique for odontoid fracture clinical curative effect and application value.Methods:From July 2005 to March 2014 in the first affiliated hospital of Fujian medical university of Orthopedic Department(three of lever first-class Hospita) for 42 cases of odontoid processes II and shallow III fracture patients were retrospectively analyzed.The male 25 cases, female 17 cases,Aged 15-71,an average of 34±3.2 years old.Using road hollow tension screw internal fixation treatment of anterior portion through intraoperative fluoroscopy.Recording and analysis of all sicks with reduction time,blood loss,drainage,complications and follow-up odontoid fracture healing. Problems about application of technique were discussed and analysis.Results: The follow-up time(45±9.5) months(5~108months).Single pieces of screws(38±1.2) mm(36~40 mm) fixed,operation time(85±15.4) min(60~110min), operative blood loss was(30±7.5) ml(10~50ml), postoperative drainage was(23 ± 6.2) ml(10 ~ 50 ml),hospitalization days(16 ± 3.8) days(11~ 21 days).the healing time was(16.5 ± 2.5)w(12~24w).Preoperativ symptoms of limited neck discomfort is obtained a good ease after the surgery,2 patients with neurological symptoms after surgery were Significant improvement.Fractures reset satisfactorily,class I grade a healing of incision, without Swallowing bitterness、 infection of nouns、expiratory dyspnea、screw shift and fracture complications.3 patients on laryngeal nerve injury symptoms,by symptomatic treatment, symptoms is basic relieve.Postoperative follow-up fractures were healed,the effect is satisfied.Frankel grading(before operation, postoperative compared):type II:grade E(32 cases,35 cases),D grade(3 cases,2 cases),Grade A(2cases,0 cases);type shallow III :grade E(4 cases,5 cases),D grade(1 cases,0 cases).Conclusion: Advantages about technique of anterior single hollow tension screwfixation is small trauma, low complication rate, shorter surgery, less bleeding, quick rehabilitation et cetera,especially retain cervical physiological function,is a kind of one of safe and effective surgical techniques for the dentate fracture.To refrain from complications,the key should strictly choice indication, specification of intraoperative fine operation. Single screw fixation is used greatly by Chinese.