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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2024 | Systematic Review

Direct osteosynthesis in the treatment of atlas burst fractures: a systematic review

Authors: He-Gang Niu, Jing-Jing Zhang, Yi-Zhu Yan, Kun Yang, Yin-Shun Zhang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Abstract

Purpose

The treatment of unstable atlas fractures remains a controversial topic. The study aims at assessing the prognosis and efficacy of osteosynthesis for unstable atlas fractures through a review of the current literature and additionally aims to compare outcomes between the transoral and posterior approaches.

Methods

A systematic review of databases including PubMed, EMBASE, Cochrane, Web of Science, CNKI, and Wanfang was conducted. Titles and abstracts were screened by two reviewers to identify studies meeting pre-defined inclusion criteria for comprehensive analysis.

Results

The systematic review included 28 articles, 19 employing the posterior approach and 9 utilizing the transoral approach. It covered osteosynthesis in 297 patients with unstable atlas fractures, comprising 169 treated via the posterior approach and 128 via the transoral approach. Analysis revealed high healing rates and clinical improvement in both approaches, evidenced by improvements in the visual analog scale, range of motion, atlantodens interval, and lateral displacement distance post-surgery.

Conclusion

Osteosynthesis offers effective treatment for unstable atlas fractures. Both transoral and posterior approaches can achieve good clinical outcomes for fracture, and biomechanical studies have confirmed that osteosynthesis can maintain the stability of the occipitocervical region, preserve the motor function of the atlantoaxial and occipito-atlantoaxial joints, and greatly improve the quality of life of patients. However, variations exist in the indications and surgical risks associated with each method, necessitating their selection based on a thorough clinical evaluation of the patient's condition.

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Title: Direct osteosynthesis in the treatment of atlas burst fractures: a systematic review
Authors: He-Gang Niu
Jing-Jing Zhang
Yi-Zhu Yan
Kun Yang
Yin-Shun Zhang
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-024-04571-9

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Springer Medicine

Direct osteosynthesis in the treatment of atlas burst fractures: a systematic review

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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