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本文报道5例6～9岁女孩因肩部摔伤致锁骨骨折(其中3例为青枝骨折)合并环枢关节旋转固定(AARF)。表现为斜颈,头左旋3例,右旋2例。前3例诊断耽误3～11个月,最后均行原位环枢关节融合术。随着经验的积累,后2例均在2周内明确诊断,采用简单的头部牵引而达到环枢关节的完全复位。众所周知,环枢关节旋转固定是儿童斜颈的少见原因,它常与颈部旋转损伤或上呼吸道感染有关。锁骨骨折合并AARF以前未见报道。本组4例首次就诊已有斜颈,另1例3周后复查时发现斜颈,但未能立即想到AARF。 AARF似由颈部强迫旋转加屈曲造成,这符合肩部及头侧着地的损伤机理。儿童的小关
This article reports five cases of 6 to 9-year-old girl suffered from clavicular fracture (including 3 cases of green branch fracture) caused by shoulder drop joint rotation and rotation fixation (AARF). Showed torticollis, head left 3 cases, right 2 cases. The first three cases of diagnosis delayed 3 to 11 months, and finally performed in situ axial arthrodesis. With the accumulation of experience, the latter 2 cases were diagnosed within 2 weeks, using a simple head traction to achieve a complete reduction of the pivot joint. As we all know, the rotation of the pivot joint fixation is a rare cause of torticollis in children, it is often associated with cervical rotation injury or upper respiratory tract infection. Clavicular fractures with AARF have not been previously reported. The group had 4 cases of first visit had a torticollis, another case of 3 weeks after the review found torticollis, but failed to immediately think of AARF. AARF seems to be forced by rotation of the neck plus flexion, which is consistent with the damage mechanism of the shoulder and the cephalic ground. Children’s off