Anterior operative approach for the treatment of old inferior-cervical fracture-dislocation

Objective:To explore the choice of operative approach for old inferior-cervical fracture-dislocation and analyze the clinical effects of anterior operative approach. Methods:From January 2003 to May 2010,17 patients with inferior-cervical fracture-dislocation delayed for more than 4 weeks were treated with continued closed skull traction and anterior decompression,bone graft and internal fixation with steel plate. Among the patients,11 patients were male and 6 patients were female,with an average age of 41 years(ranged from 24 to 56 years). The time between injury and operation was from 4 weeks to 3 months. According to Frankel grade, grade A was in 7 cases,B in 4,C in 2,D in 2,E in 2. Neurological function,bone fusion, height of vertebral body and cervical sequence and curvature were observed. Results:The incision of 17 cases obtained primary healing. There was 1 case with hoarseness,and symptoms disappeared after 1 month. The mean time of follow-up was 23 months(ranged from 4 to 47 months). The X-ray films showed satisfactory reduction and good alignment and lordosis. The Frankel grade improved obviously at final follow-up,grade A was in 5 cases,B in 5,C in 1,D in 3,E in 3. Conclusion:Single anterior operative approach can successfully reduce old inferior-cervical fracture-dislocation of DF stageⅠ,Ⅱand some stageⅢ;anterior decompression,bone graft and internal fixation with steel plate is a safe,effective method for old inferior-cervical fracture-dislocation.