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患儿男,3岁,因车祸致颈部疼痛,活动受限入院。查体:行走时头略向左前倾斜,C_(1、2)棘突明显压痛,颈部活动:前屈5°,后伸0°,侧屈:左5°,右3°,左右旋转各5°,四肢肌力正常,活动无受限,无感觉障碍。X线片示:枢椎齿状突基底部骨折伴寰枢椎完全脱位。入院后即给予颅骨牵引,先略屈曲位,重量0.5kg开始,在严密监护下逐渐增加牵引重量,床边定时拍片复查,3d后骨折脱位完全复位,中立位0.3kg维持牵引,3周后改用头颈胸石膏固定3个月,骨折愈合。随访半年,无疼痛,无神经系统症状。
Male child, 3 years old, caused by a car accident neck pain, restricted access to hospital. Physical examination: walking head slightly tilted to the left before, C_ (1,2) spinous process was tender tenderness, neck activity: 5 ° flexion, extension 0 °, lateral flexion: left 5 °, right 3 °, left and right rotation 5 °, normal muscle strength, activity is not limited, no sensory disturbances. X-ray showed: the bottom of the odontoid fracture with atlantoaxial complete dislocation. After admission to give the skull traction, the first slightly flexion position, the weight of 0.5kg began to gradually increase the traction weight under close supervision, the bedside regular film review, 3d complete dislocation dislocation, neutral 0.3kg to maintain traction, 3 weeks after the change Head and neck plaster immobilized for 3 months, fracture healing. Follow-up for six months, no pain, no neurological symptoms.