Hangman骨折及其不同外科治疗策略的生物力学差异

doi:10.13418/j.issn.1001-165x.2025.4.22

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中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (4) : 491-497. DOI: 10.13418/j.issn.1001-165x.2025.4.22

综述

Hangman骨折及其不同外科治疗策略的生物力学差异

何英华¹，刘彦凇¹，梁钟标¹，孙昊²，陈虎³，谢宁灵³，涂强^1,2,3*

作者信息 +

Biomechanical differences between Hangman's fracture and its various surgical treatment strategies

He Yinghua¹, Liu Yansong¹, Liang Zhongbiao¹, Sun Hao², Chen Hu³, Xie Ningling³, Tu Qiang^1,2,3*

Author information +

文章历史 +

摘要

为系统评价Hangman骨折不同分型及其治疗方法的生物力学特征，为临床手术方案提供循证依据，以“Hangman”和“生物力学”为关键词检索PubMed、中国知网（CNKI）等数据库并进行分析。结果显示：稳定型骨折（Ⅰ型）非手术治疗与不稳定型骨折（Ⅱ、Ⅱa型及Ⅲ型）手术治疗，在准确分型前提下均能获得良好生物力学稳定性及远期疗效。结论表明：Hangman骨折可分为稳定型与不稳定型，前路及后路手术均能重建颈椎稳定性。生物力学研究显示，伴前纵韧带及椎间盘损伤时，C2~3前路椎间盘切除融合术即刻稳定性更优；后路单节段生理性内固定可保留C1~2旋转功能，但对C2~3失稳纠正不足；后路C2~3内固定融合术生物力学刚度更高，而C1~3长节段固定虽牺牲寰枢活动度，却在屈伸、侧弯和旋转方面表现出更高的刚度和稳定性，临床可通过临时长节段固定策略平衡功能与稳定。

Abstract

To systematically evaluate the biomechanical characteristics of various types of Hangman's fractures and their corresponding treatment strategies, thereby providing an evidence-based foundation for clinical decision-making. Relevant literature was retrieved and analyzed from databases such as PubMed and CNKI (China National Knowledge Infrastructure) using the keywords "Hangman" and "biomechanics."The results indicated that non-surgical treatment for stable fractures (Type I) and surgical intervention for unstable fractures (Types II, IIa, and III) can achieve favorable biomechanical stability and long-term outcomes, provided the fracture is accurately classified. Hangman's fractures can be divided into stable and unstable types, and both anterior and posterior surgical approaches are effective in restoring cervical spine stability.Biomechanical analyses have demonstrated that in cases involving injuries to the anterior longitudinal ligament and intervertebral disc, C2~3 anterior cervical discectomy and fusion (ACDF) offers superior immediate stability. Posterior single-segment physiological fixation preserves C1~2 rotational function to the greatest extent but fails to address C2~3 instability. In contrast, posterior C2~3 fixation and fusion provides higher mechanical stiffness and more effectively stabilizes the fracture site. C1~3 long-segment fixation and fusion offers greater stiffness and multidirectional stability in flexion-extension, lateral bending, and rotational movements. However, it compromises atlantoaxial mobility-a drawback that can be mitigated by employing temporary long-segment fixation.

导出引用

何英华, 刘彦凇, 梁钟标, 孙昊, 陈虎, 谢宁灵, 涂强. Hangman骨折及其不同外科治疗策略的生物力学差异[J]. 中国临床解剖学杂志. 2025, 43(4): 491-497 https://doi.org/10.13418/j.issn.1001-165x.2025.4.22

He Yinghua, Liu Yansong, Liang Zhongbiao, Sun Hao, Chen Hu, Xie Ningling, Tu Qiang. Biomechanical differences between Hangman's fracture and its various surgical treatment strategies[J]. Chinese Journal of Clinical Anatomy. 2025, 43(4): 491-497 https://doi.org/10.13418/j.issn.1001-165x.2025.4.22

中图分类号： R318.01 R683.2

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