We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Unilateral lag-screw technique for an isolated anterior 1/4 atlas fracture.
- Authors
Keskil, Semih; Göksel, Murat; Yüksel, Ulaş
- Abstract
Study Design: Fractures of the atlas are classified based on the fracture location and associated ligamentous injury. Among patients with atlas fractures treated using external immobilization, nonunion of the fracture could be seen. Objective: Ideally, treatment strategy for an unstable atlas fracture would involve limited fi xation to maintain the fracture fragments in a reduced position without restricting the range of motion (ROM) of the atlantoaxial and atlantooccipital joints. Summary of Background Data: Such a result can be established using either transoral limited internal fi xation or limited posterior lateral mass fi xation. However, due to high infection risk and technical difficulty, posterior approaches are preferred but none of these techniques can fully address anterior 1/4 atlas fractures such as in this case. Materials and Methods: A novel open and direct technique in which a unilateral lag screw was placed to reduce and stabilize a progressively widening isolated right-sided anterior 1/4 single fracture of C1 that was initially treated with a rigid cervical collar is described. Results: Radiological studies made after the surgery showed no implant failure, good cervical alignment, and good reduction with fusion of C1. Conclusions: It is suggested that isolated C1 fractures can be surgically reduced and immobilized using a lateral compression screw to allow union and maintain both C1-0 and C1-2 motions, and in our knowledge this is the fi rst description of the use of a lag screw to achieve reduction of distracted anterior 1/4 fracture fragments of the C1 from a posterior approach. This technique has the potential to become a valuable adjunct to the surgeon's armamentarium, in our opinion, only for fractures with distracted or comminuted fragments whose alignment would not be expected to significantly change with classical lateral mass screw reduction.
- Subjects
ATLAS vertebra injuries; BONE screws; RANGE of motion of joints; ATLANTO-occipital joint; ORTHOPEDIC implant complications; SOMATOSENSORY evoked potentials; WOUNDS &; injuries; SURGERY
- Publication
Journal of Craniovertebral Junction & Spine, 2016, Vol 7, Issue 1, p50
- ISSN
0974-8237
- Publication type
Case Study
- DOI
10.4103/0974-8237.176625