摘要
目的:分析机动车事故所导致Hangman骨折患者的临床特征。方法:从多中心Hangman骨折数据库中(数据来源于西南医科大学附属医院、四川大学华西医院等7个医学中心)提取由于机动车事故所致Hangman骨折患者临床资料,并对患者性别、年龄、骨折类型(Levine-Edwards分型)、合并伤及治疗方式等数据进行统计分析。结果:在数据库221例患者中共筛选出符合条件的患者72例,男52例,女20例,平均年龄41岁(15~71岁),≤64岁的青壮年患者占93.1%,男女比例为2.6∶1。依据Levine-Edwards分型,不稳定骨折46例,占63.9%,其中Ⅱ、Ⅱa和Ⅲ型分别为35、7和4例;稳定骨折26例。依据枢椎环骨折解剖分型,波及一侧或双侧C2上关节突和/或椎体后壁的不典型Hangman骨折52例(其中B1、B2、C1、C2型骨折分别为20、26、4、2例);一侧或双侧峡部-椎弓根断裂为特征的典型Hangman骨折20例(A1型5例,A2型15例),不典型骨折占多数(72.2%)。共69例患者存在合并伤,发生率为95.8%,合并头面部损伤44例次,脊柱与骨盆相关损伤38例次,胸部损伤25例次,四肢骨折19例次,发生率分别为61.1%、52.8%、34.7%及26.4%。合并上述三个及以上部位的患者共26例,占比为36.1%。在治疗方式的选择方面,共43例患者选择内固定手术治疗(其中前路、后路及前后联合手术患者分别为9、33、1例),占比59.7%。结论:由机动车事故所致的Hangman骨折患者中以青壮年男性为主要受伤人群,骨折类型以不稳定、不典型骨折多见,且绝大多数存在其他部位的合并伤。大部分患者需要接受外科手术治疗,手术方式以后路固定融合术式为主。
Objectives:To analyze the clinical features in patients with Hangman′s fracture caused by motor vehicle accidents.Methods:The clinical records of Hangman′s fracture patients caused by motor vehicle accidents were extracted from multicenter Hangman′s fracture database(Data from 7 medical centers such as the Affiliated Hospital of Southwest Medical University and West China Hospital of Sichuan University,etc),and the data of gender,age,fracture type(Levine-Edwards classification),combined injury,and treatment were systematically analyzed.Results:A total of 72 eligible patients were selected from the total 221 patients in the database,including 52 males and 20 females(Male to female ratio was 2.6∶1),with an average age of 41 years(15-71 years old,93.1% of young and middle-aged patients≤64 years old).According to the Levine-Edwards classification,46 cases out of the 72(63.9%)were of unstable fractures(Type Ⅱ,35 cases;Type Ⅱa,7 cases;Type Ⅲ,4 cases)and 26 cases were of stable fractures.According to the anatomical classification of axial ring fractures,52 cases were of atypical Hangman′s fracture(72.2%)which affecting the superior facet of unilateral or bilateral C2 and/or the posterior wall of the vertebral body(Type B1 fracture,20;B2 fracture,26;C1 fracture,4;C2 fracture,2),and the other 20 cases were of typical Hangman′s fracture characterized with unilateral or bilateral pars interarticularis-pedicle fracture(Type A1,5;Type A2,15).A total of 69 patients had combined injuries,with an incidence rate of 95.8%,including 44 cases of combined head and facial injuries(61.1%),38 cases of spinal and pelvic related injuries(52.8%),25 cases of chest injuries(34.7%),and 19 cases of limb fractures(26.4%).A total of 26 patients(36.1%)combined with injuries in the above three sites or more.In terms of the choice of treatment methods,a total of 43 patients(59.7%)underwent internal fixation surgery(9 cases of anterior,33 cases of posterior and 1 case of combined anterior and posterior surgery).Conclusions:Young
作者
雷舒澳
王清
李广州
刘浩
王高举
张建
张浩
张鹏鑫
LEI Shuao;WANG Qing;LI Guangzhou(Department of Orthopedics,tthe Affiliated Hospital of Southwest Medical University,Luzhou,646000,China)
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2023年第7期577-583,共7页
Chinese Journal of Spine and Spinal Cord
基金
四川省医学青年创新课题(Q19038)
西南医科大学附属医院博士启动基金项目(Q19081)。
