title: Management of combination fractures of the atlas and axis: a report of four cases and literature review.
abstract: Four cases of combination fractures of the atlas and axis are presented. Three types of management were performed: plaster immobilization, odontoid screw fixation combined with atlantoaxial pedicle screw fixation, occipito-cervical fusion with anterior operation by staged. Based on a literature review and our experience, treatment strategies is discussed according to the stability of the upper cervical spine and neurological involvement, with a reminder that combined injuries in the upper cervical spine should be sought in any patient with a cervical injury and early surgical solution may bring benefits once injury attack.
authors.affiliation: Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Orthopedic Surgery, Zaozhuang Hosptial of Zaozhuang Mining Corporation Zaozhuang, China.
authors.forename: Linghao
authors.initials: L
authors.lastname: Kuang
authors.affiliation: Department of Orthopaedics, Shanghai Jiaotong University Affiliated First People's Hospital Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Shanghai Jiaotong University Affiliated First People's Hospital Shanghai, China.
authors.forename: Jiwei
authors.initials: J
authors.lastname: Tian
keywords: Cervical spine fracture; atlas; axis; cervical spine surgery; plaster immobilization