title: Transoral atlantoaxial reduction plate fixation for irreducible atlantoaxial dislocation.
abstract: OBJECTIVE
  To design a clinically applicable transoralpharyngeal atlantoaxial reduction plate (TARP), introduce the operation procedure, and evaluate its preliminary clinical effects.
  
  
  METHODS
  A novel TARP system, including butterfly titanium alloy plate, self-locking screws, atlantoaxial reductor and other operational instruments was developed. This system was applied clinically on five patients with irreducible atlantoaxial dislocation of congenital or traumatic origin. During operation, the reduction was completed by the combined action of the plate and the atlantoaxial reductor after transoral joint release and cord decompression. Bone graft granules were implanted between the bilateral atlantoaxial joints and TARP was used to immobilize subsequently the atlas and axis.
  
  
  RESULTS
  Clinical application demonstrated that TARP could induce instant reduction and that the method was operationally feasible and its postoperational effect was satisfactory.
  
  
  CONCLUSIONS
  The design of TARP is novel. The operational procedure is simple and easy to use. Furthermore, instant reduction can be completed during the operation and the fixation is relatively stable. TARP is an ideal alternative for irreducible atlantoaxial dislocation and may have excellent prospects for further clinical applications.
authors.affiliation: Department of Orthopedics, Liuhuaqiao Hospital, Guangzhou 510010, China. yqs53809-gzb@21cn.net
authors.forename: Qing-shui
authors.initials: QS
authors.lastname: Yin
authors.forename: Fu-zhi
authors.initials: FZ
authors.lastname: Ai
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.forename: Yun-bing
authors.initials: YB
authors.lastname: Chang
authors.forename: Hong
authors.initials: H
authors.lastname: Xia
authors.forename: Zeng-hui
authors.initials: ZH
authors.lastname: Wu
authors.forename: Ri
authors.initials: R
authors.lastname: Quan
authors.forename: Xiao-hong
authors.initials: XH
authors.lastname: Mai
authors.forename: Jing-fa
authors.initials: JF
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D001268:Atlanto-Axial Joint / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D019299:Decompression, Surgical / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D016268:Internal Fixators; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D009055:Mouth / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*