Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique
Background: Levine Edward's Type III Hangman's fractures are highly unstable and in absence of level 1 evidence, the treatment is individualized. A longer cantilever beam can achieve not just reduction of highly displaced fragments but can also provide a stable construct without the need o...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=80;epage=84;aulast=Mudumba |
| _version_ | 1811240591637348352 |
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| author | Vijaya Saradhi Mudumba S Pavan Rajesh Alugolu |
| author_facet | Vijaya Saradhi Mudumba S Pavan Rajesh Alugolu |
| author_sort | Vijaya Saradhi Mudumba |
| collection | DOAJ |
| description | Background: Levine Edward's Type III Hangman's fractures are highly unstable and in absence of level 1 evidence, the treatment is individualized. A longer cantilever beam can achieve not just reduction of highly displaced fragments but can also provide a stable construct without the need of global instrumentation.
Objective: We extrapolated the surgical techniques of the long cantilever beam to this rare group of cohorts for anterior alone, sequential reduction utilizing C3 rather than sacrificing in a single sitting and single approach.
Materials and Methods: This is a prospective observational study from 2015 to 2019, of all consecutive 10 patients diagnosed and treated as Type III Hangman's fracture in the Department of Neurosurgery. Clinical evaluation and pain scores were recorded in the preoperative assessment. Radiological investigations included plain roentgenograms in anterior-posterior and lateral views, magnetic resonance imaging, and computed tomography scan of the cervical spine. Preoperative cervical traction was placed in all cases for the achievement of facetal reduction. The high cervical extra-pharyngeal approach was utilized for discectomy, bone grafting, reduction, and sequential plating.
Results: Complete reduction was achieved in all the cases and none required additional posterior surgery. There was a significant decrease in axial neck pain with complete fusion of the graft, and healing of fracture site.
Conclusion: The anterior alone approach with a longer cantilever for primary internal stabilization is a technically safe and suitable option for unstable Type III Hangman's fracture. |
| first_indexed | 2024-04-12T13:22:55Z |
| format | Article |
| id | doaj.art-540b5a1c853042b19765e08937324c54 |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-04-12T13:22:55Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-540b5a1c853042b19765e08937324c542022-12-22T03:31:25ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372022-01-01131808410.4103/jcvjs.jcvjs_83_21Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel techniqueVijaya Saradhi MudumbaS PavanRajesh AlugoluBackground: Levine Edward's Type III Hangman's fractures are highly unstable and in absence of level 1 evidence, the treatment is individualized. A longer cantilever beam can achieve not just reduction of highly displaced fragments but can also provide a stable construct without the need of global instrumentation. Objective: We extrapolated the surgical techniques of the long cantilever beam to this rare group of cohorts for anterior alone, sequential reduction utilizing C3 rather than sacrificing in a single sitting and single approach. Materials and Methods: This is a prospective observational study from 2015 to 2019, of all consecutive 10 patients diagnosed and treated as Type III Hangman's fracture in the Department of Neurosurgery. Clinical evaluation and pain scores were recorded in the preoperative assessment. Radiological investigations included plain roentgenograms in anterior-posterior and lateral views, magnetic resonance imaging, and computed tomography scan of the cervical spine. Preoperative cervical traction was placed in all cases for the achievement of facetal reduction. The high cervical extra-pharyngeal approach was utilized for discectomy, bone grafting, reduction, and sequential plating. Results: Complete reduction was achieved in all the cases and none required additional posterior surgery. There was a significant decrease in axial neck pain with complete fusion of the graft, and healing of fracture site. Conclusion: The anterior alone approach with a longer cantilever for primary internal stabilization is a technically safe and suitable option for unstable Type III Hangman's fracture.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=80;epage=84;aulast=Mudumbafixationfusionhangman's fracturelonger cantileversequential reduction |
| spellingShingle | Vijaya Saradhi Mudumba S Pavan Rajesh Alugolu Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique Journal of Craniovertebral Junction and Spine fixation fusion hangman's fracture longer cantilever sequential reduction |
| title | Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique |
| title_full | Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique |
| title_fullStr | Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique |
| title_full_unstemmed | Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique |
| title_short | Saradhi's single stage, anterior sequential reduction utilizing C3 for type III hangman's fracture: A novel technique |
| title_sort | saradhi s single stage anterior sequential reduction utilizing c3 for type iii hangman s fracture a novel technique |
| topic | fixation fusion hangman's fracture longer cantilever sequential reduction |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2022;volume=13;issue=1;spage=80;epage=84;aulast=Mudumba |
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