Treatment of Atlantoaxial Rotatory Fixation.

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  • 環軸椎回旋位固定の治療方針の検討

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Abstract

This study was counducted on 41 patients with atlantoaxial rotatory fixation (AARF) consisting of 24 males and 17 females, whose age ranged from 3 to 26 years with an average age of 7.1 years, and who were seen at our hospital zero to 53 days after AARF onset. Nine patients were treated by neck color fixation, 31 patients treated by Glisson’s traction and one was lying on the bed with the neck fixed by the sandbags primarily. In 5 of the 9 patients treated by the neck color, torcicollis, restricted neck motion, and pain did not improve and therefore they were treated by Glisson’s traction. In all patients treated by Glisson’s traction, torcicollis and neck pain improved completely. However, 4 patients (according to Fielding’s classification: type-1; two patients and type-2; two) sustained recurrence. Three patients with the recurrence were not fixed by neck color after correction of deformity Glisson’s traction. A patient who was injured in falling (major trauma) was fixed by the neck color after the correction of deformity. These results suggest that AARF induced by major trauma should be primarily treated by Glisson’s traction, and additional neck color fixation should be done after correction of deformity by Glisson’s traction.

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