atlas fracture dislocation
Introduction
Introduction to atlas fracture and dislocation Axillary fracture and dislocation is a common type of upper cervical spine injury, accounting for about 50%. Clinically seen fractures and dislocations of the atlas, the neurological symptoms are different, some died on the spot, some cases are severely accompanied by different degrees of brain stem and spinal cord high-level injury, manifested as cranial nerve spasm, quadriplegia or incomplete paralysis and breathing Obstacles, often need immediate assisted breathing, some are only occipital neck pain and movement disorders, neurological symptoms are mild, but these patients are still potentially dangerous, should be highly valued and treated accordingly. basic knowledge The proportion of sickness: 0.004% - 0.007% Susceptible people: no specific population Mode of infection: non-infectious Complications:
Cause
Causes of atlas fracture and dislocation
Cause:
The disease occurs when an object falling from a height hits the top of the head, or falls from a height, and the top of the head is vertically touched to the ground. The atlas is connected to the occipital bone and other cervical vertebrae. It is an atypical spine with an elliptical appearance. There is no vertebral body, thickening and thickening on both sides of the ring, called the side block, the upper and lower surfaces are obliquely inward and forward in front, and the anterior and posterior vertebral arch extending from the side block is the weakest part of the atlas. It is also the most common fracture site. When the accumulation of violence and reaction forces on the atlas, due to the introversion of the superior and inferior articular surfaces of the atlas, the combined force of violence and reaction forces causes the sacral vertebral block to undergo eccentric violent and thus before and after the atlas The fracture occurs at the weakest part of the junction between the arch and its lateral mass. This fracture, also known as the Jefferson fracture, is characterized by four fractures of the atlanto-vertebral fracture, forming four fracture segments, namely two lateral blocks and two front and rear arches. When the direction of violence is not correct, only on the side of the head or when the head tends to be violent, it can cause a vertebral arch fracture and occasionally cause a lateral block fracture.
Prevention
Prevention of atlas fracture and dislocation
At present, there are no effective preventive measures, and the diagnosis should be confirmed as soon as possible and treated early. The disease is caused by traumatic cervical spine damage, such as a direct car accident. Therefore, pay attention to living habits, high-risk workers, such as construction workers, mining workers are prone to damage, should pay attention to protect themselves in the course of work.
Complication
Complications of atlas fracture and dislocation Complications
Serious injury to the disease can cause paralysis or even death immediately.
Symptom
Atlas fracture and dislocation symptoms common symptoms head and neck activity limited ligament rupture respiratory abnormality
The neck is sore and stiff, and the patient often holds the head with both hands to avoid their activities. For example, when the second cervical nerve (occipital nerve) is involved, the patient feels occipital pain, cervical tendon, and limited neck activity. If accompanied by spinal cord injury, there may be loss of motor sensation. Severe injuries can cause paralysis or even death immediately.
Examine
Examination of atlas fracture and dislocation
1. Need to open the X-ray film, lateral X-ray film, and measure the compression fracture of the atlas and the instability of the atlantoaxial axis on the open position piece. The normal lateral margin of the atlas and the lateral axon of the atlas The outer edge is on the same straight line, the bilateral lateral mass of the atlas fracture is outwardly displaced, the outer edge of the lateral block exceeds the outer edge of the axial joint, and the distance of the lateral block is measured, and the sum of the two sides exceeds 6.9 mm. It is indicated that the transverse ligament of the atlanto-axial ligament is broken, resulting in instability of the atlantoaxial axis. Double fractures of the posterior arch of the atlas can be seen on the lateral X-ray film.
2. In order to understand the changes of the fine structure of the injury in the atlanto-bone area, it is advisable to use the fault film and CT scan, which often shows the fracture separation of the atlas burst, which is beneficial for determining the stability of the iliac crest. Avulsion fracture, because it is a sign of transverse ligament tear, suggesting fracture instability.
Diagnosis
Diagnosis and diagnosis of atlas fracture and dislocation
According to clinical manifestations and related examinations can be diagnosed.
According to the fracture site and displacement, the atlas fractures are divided into three types, which must be identified from each other:
Type I: posterior arch fracture of the atlas, which is caused by over-extension and longitudinal axis violence between the occipital condyle and the spinal spinous process, and is caused by mutual external force, and can also be associated with the second cervical vertebrae or odontoid fracture. Concurrent.
Type II: Lateral mass fracture of the atlas is more common on one side, and the fracture line passes through the posterior part of the atlas joint, sometimes involving the vertebral artery.
Type III: anterior and posterior arch fractures of the atlas, that is, fractures in the anterior and posterior segments of the lateral mass, also known as Jefferson fractures, which are the result of simple vertical violence.
