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Journal of Korean Neurosurgical Society 1997;26(4): 578-583.
Direct Reduction and Fixation for Unstable Hangman's Fracture with Posterior Lateral Mass Plating: Report of 4 Cases.
Tae Ahn Jahng
Department of Neurosurgery, School of Medicine, Wonkwang University, Iksan, Korea.
While most patients with hangman's fracture could be effectively managed with non-operative treatment, surgical intervention should be considered in unstable hangman's fracture with severe C2-3 dislocation or angulation. Author modified the posterior lateral mass plating techinic for the unstable hangman's fracture. While the C3 screw fixation was done with usual manner, author applied the long lag screw instead of usual short- or medium-sized screw through the isthmus of C2 for direct reduction and fixation of fractured segment. It is similar to anterior screw fixation for odontoid type II fracture in terms of simutaeneous reduction and fixation. Besides these procedure interfacetal fusion and ligamentoplasty were added in C2-3 articulation. Surgical point of view was discussed with literature review.
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