Pedicle screw fixation for treatment of the unstable Hangman fractures

Objective To investigate the clinical effects of pedicle screw fixation in the treatment of unstable Hangman fractures. Methods From October 2001 to April 2006, 15 patients with the unstable Hangman fractures were treated by the pedicle screw fixation after skull traction and reduction through posterior cervical approach. By Levine-Edwards classification, there were 3 cases of Ⅱ type, 4 cases of ⅡA type, 8 cases of Ⅲ type. Results The mean follow-up time was 17 (3 to 30) months. Six cases of Grade D by Frankel classification recovered to Grade E. Postoperative X-rays revealed bony union in all cases. No screw loosening or obvious functional limitation of the cervical vertebrae was found. In the cases of incomplete reduction, C2, 3 fixation was performed for patients without severe dislocation, and additional CA fixation with lateral mass screw was supplemented for patients with serere dislocation. Conclusion Posterior pedicle screw fixation of C2,3 or C2-4 is an effective and safe method for treating the unstable Hangman fractures. Key words: Axis; Fracture; Fracture fixation, internal; Surgical treatment