| 雷舒澳,王 清,李广州,刘 浩,王高举,张 建,张 浩,张鹏鑫.机动车事故致Hangman骨折的临床特征分析：一项基于多中心数据的回顾性研究[J].中国脊柱脊髓杂志,2023,(7):577-583. |
| 机动车事故致Hangman骨折的临床特征分析：一项基于多中心数据的回顾性研究 |
| 中文关键词: Hangman骨折 临床特征 多中心研究 回顾性研究 机动车事故 |
| 中文摘要: |
| 【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。 |
Analysis of clinical features of Hangman′s fracture caused by motor vehicle accidents: a retrospective study based on multicenter clinical data |
| 英文关键词:Hangman′s fracture Clinical features Multicenter studies Retrospective study Motor vehicle accident |
| 英文摘要: |
| 【Abstract】 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 and middle-aged males are the main population injured in Hangman′s fracture caused by motor vehicle accidents, with unstable and atypical fractures as the main, and most of them have concurrent injuries in other parts. A large majority of the patients need to undergo surgical treatment, mainly through posterior fixation and fusion. |
| 投稿时间：2022-11-02 修订日期：2023-04-27 |
| DOI： |
| 基金项目: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） |
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