Objective To observe the clinical outcomes of Hangman fracture treated by anterior cervical discectomy and fusion. Methods A total of 41 patients with Hangman fracture were retrospectively analyzed, who underwent anterior cervical discectomy and fusion from May 2010 to May 2016. Intervertebral bone graft fusion was observed through postoperative radiographic images, and improvement of symptoms was evaluated by Visual Analogue Scale (VAS), Neck Disability Index (NDI) and Modified Japanese Orthopaedic Association Scale (m-JOA). Surgical complications were evaluated as well. Results No severe complications occurred after surgery, but 5 patients had a transient dysphagia, which relieved spontaneously. Thirty-five patients had a fusion of intervertebral bone graft 3 months after surgery, and the remaining 6 patients did at the last follow-up. The VAS score was improved from 4.5±1.6 pre-operatively to 2.4±1.7 immediately post-operatively (P>0.05), and was further improved to 0.7±0.9 at the last follow-up (P<0.05). The NDI score was improved from 29.3±10.9 pre-operatively to 13.2±5.4 immediately post-operatively (P<0.05), and was further improved to 4.6±3.1 at the last follow-up (P<0.05). The m-JOA score was improved from 8.4±2.3 pre-operatively to 11.6±3.5 immediately post-operatively (P<0.05), and was further improved to 14.3±2.0 at the last follow-up (P<0.05). Conclusion Anterior cervical discectomy and fusion can be used in Hangman fracture, which is safe and reliable.
ObjectiveTo evaluate the clinical therapeutic effect of support plates on Schatzker type Ⅳ tibial plateau fractures.MethodsPatients with Schatzker type Ⅳ tibial plateau fractures underwent support plates treatment between April 2013 and September 2014 by using the medial incision or posterior medial incision, if necessary, with other auxiliary incisions, with limited contact compression plate, 1/3 tubular plate or " T” plate to support the fracture. ResultsA total of 14 patients including 6 males and 8 females with an average age of (35.2±9.8) years (ranged from 20 to 52 years) were enrolled in this study and followed up for 12–25 months with an average of (16.3±4.0) months. The knee joints were flexed 80–130° with an average of (97.9±13.1)° one month after the surgery and 90–140° with an average of (119.3±12.1)° three months after the surgery. One year postoperatively, the mean Hospital of Special Surgery knee score ranged from 78 to 96 with an average of 88.4±4.9. Last follow-up assessment of knee function according to Rasmussen scoring system showed excellent in 8 cases, good in 4 cases, and fair in 2 cases; the excellent and good rate was 85.7%. No postoperative complications such as infection, nonunion, vascular nerve injury, or internal fixation failure occurred. ConclusionThe support plates for the treatment of Schatzker type Ⅳ tibial plateau fractures can maintain good reduction, prevent the secondary collapse of the tibial plateau, ensure that knee joint has good alignment, less complications with vascular or nerve injuries, and finally get a satisfied function recovery.