| Comparison of transoral anterior Jefferson-fracture reduction plate and posterior screw-rod fixation in C1-ring osteosynthesis for unstable atlas fractures |
Mandi Cai1,2 
, Yifeng Wu1,2, Rencai Ma2, Junlin Chen1,2, Zexing Chen1,2, Chenfu Deng2, Xinzhao Huang1,2, Xiangyang Ma1,2, Xiaobao Zou2
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1The First School of Clinical Medicine, Southern Medical University, No.1838 North of Guangzhou Road, Guangzhou, 510515, China
2Department of Orthopedics, General Hospital of Southern Theatre Command of PLA, 111 Liuhua Road, Guangzhou, 510010, China |
Corresponding Author:
Xiangyang Ma
Email: zouxb6478@126.com
Xiaobao Zou
Email: zouxb6478@126.com
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Received: November 18, 2023 Revised: January 14, 2024 Accepted: January 15, 2024 |
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| Abstract |
Objective
To compare the clinical outcomes of transoral anterior Jefferson fracture reduction plate (JeRP) and posterior screw rod (PSR) surgery for unstable atlas fractures via C1-ring osteosynthesis.
Methods
From June 2009 to June 2022, 49 consecutive patients with unstable atlas fractures were treated by transoral anterior JeRP fixation (JeRP group) or PSR fixation (PSR group) and followed up at our hospital; 30 males and 19 females were included. The visual analogue scale (VAS) score, neck disability index (NDI), distance to anterior arch fracture (DAAF), distance to posterior arch fracture (DPAF), lateral mass displacement (LMDs), Redlund-Johnell value, postoperative complications, and fracture healing rate were retrospectively collected and statistically analyzed.
Results
Compared with that in the PSR group, the bleeding volume in the JeRP group was lower, and the length of hospital stay was longer. The VAS scores and NDIs of both groups were significantly improved after surgery. The postoperative DAAF and DPAF were significantly smaller after surgery in both groups. Compared with the significantly shorter DPAF in the PSR group, the JeRP group had a smaller DAAF, shorter LMDs and larger Redlund-Johnell value postoperatively and at the final follow-up. The fracture healing rate at 3 months after surgery was significantly greater in the JeRP group (P<0.05).
Conclusion
Both C1-ring osteosynthesis procedures for treating unstable atlas fractures yield satisfactory clinical outcomes. Transoral anterior JeRP fixation is more effective than PSR fixation for holistic fracture reduction and short-term fracture healing, but the hospital stay is longer. |
| Keywords:
Atlas fracture, Unstable fractures, Transoral anterior approach, Posterior approach, C1-ring osteosynthesis |
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