title: [Transoral plate internal fixation for treatment of instability atlas fracture].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of transoral plate internal fixation for instability atlas fracture.
  
  
  METHODS
  A retrospective study was performed in eight patients with instability atlas fractures, who were treated by a transoral plate internal fixation from July 2007 to June 2011. There were 6 males and 2 females,with an average age of 39.5 years old ranging from 23 to 48 years. Among them, 5 case were falling injury, 3 cases were traffic accident injury. Three patients had bilateral fractures of the anterior arch (prehalf Jefferson fractures, Landells type I), 5 had anterior are fracture associated posterior are fracture (Half-ring Jefferson fractures, Landells type II), and 2 had anterior and posterior are fracture associated with single lateral mass fractures (Landells type III).
  
  
  RESULTS
  All patients were followed up for 6 to 24 months after operation (av- eraged 13 months), and all the patients had the clinical symptoms improved to some extent. Operation time ranged from 80 to 140 min (averaged 98 min); the intra-operative blood loss was 120 to 300 ml (averaged 180 ml); and the average fluoroscopic time was 55 s. No patients happened neurological and vertebral artery injuries-related complications or other complications after operation. The followed-up X-ray and CT manifested osseous fusion in all the 8 patients,no loosening or breakage of the screws.
  
  
  CONCLUSIONS
  Transoral plate internal fixation for instability atlas fracture is a reliable and safety technique that allows maintenance of rotatory mobility in the C1,2 joint and restoration of congruency in the atlanto-occipital and atlanto-axial joints.
authors.affiliation: Department of Orthopaedics, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China. 54216055@qq.com
authors.forename: Shao-Hua
authors.initials: SH
authors.lastname: Sun
authors.forename: Jian-Li
authors.initials: JL
authors.lastname: Fang
authors.forename: Wei-Hu
authors.initials: WH
authors.lastname: Ma
authors.forename: Guan-Yi
authors.initials: GY
authors.lastname: Liu
mesh_terms: D000328:Adult; D001860:Bone Plates; D001270:Cervical Atlas / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies