Positive “Water Test”—An External Indicator of Base of Skull Hinge‐Ring Fracture

Byard, Roger W.; Langlois, Neil E. I.; Gilbert, John D.

doi:10.1111/j.1556-4029.2009.01288.x

Cited by 7 publications

(7 citation statements)

References 4 publications

(6 reference statements)

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“…The causes of death in cases of ring fracture include dislocation of the atlantooccipital junction, pontine hemorrhage, brainstem injury and vascular injuries 2) . Although sudden heart arrest caused by brain stem injury represents a leading cause of death in the field 1 , 8) , this condition remained unfamiliar to forensic doctors until recently.…”

Section: Discussionmentioning

confidence: 99%

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Pontomedullary Laceration, a Fatal Consequence of Skull Base Ring Fracture

Jang

Kim

2014

J Korean Neurosurg Soc

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Due to improvements in emergency resuscitation provided by rescue teams, more trauma victims who could have died due to sudden heart failure at the scene are brought to the hospital following resuscitation. Most of these patients present with major organ injuries and hypovolemic shock at the time of trauma. However, head trauma associated with sudden heart arrest is rare. Here, we report a case of ring fracture with pontomedullary laceration that led to sudden heart arrest.

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Section: Discussionmentioning

confidence: 99%

“…In cases of chin impact, the presence of a mandible fracture reduces the incidence of the pontomedullar laceration by 2.3-fold compared to the absence of such a fracture 12) . In addition, ring fractures can also be accompanied by cerebrospinal fluid rhinorrhea and/or otorrhea 1) .…”

Section: Discussionmentioning

confidence: 99%

Pontomedullary Laceration, a Fatal Consequence of Skull Base Ring Fracture

Jang

Kim

2014

J Korean Neurosurg Soc

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“…Deformed laminae are called hinges. 14,15 Deformed lamina fractures, also called hinge fractures, could occur intraoperatively during creation of a hinge and can occur postoperatively during the recovery stage. 16 Sometime a hinge fracture occurs regardless of the proper hinge angle.…”

Section: Introductionmentioning

confidence: 99%

Effect of Titanium Miniplate Fixation on Hinge Fracture and Hinge Fracture Displacement Following Cervical Open-Door Laminoplasty

2020

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Background: Cervical spondylotic myelopathy is a neuromotor disorder responsible for functional limitations and decreased daily activities. Expansive open-door laminoplasty is the widely accepted procedure for the treatment of multilevel cervical spondylotic myelopathy. Among the various fixation procedures to secure the open lamina, miniplate fixation provides better clinical and radiological outcomes. However, the immediate effects on hinge fracture and hinge fracture displacement following miniplate fixation have not been proven until now. The purpose of our study was to elucidate the impact of cervical open-door angle on the status of spinal cord expansion and hinge fracture, hinge fracture displacement, and the role of implants used during surgery. Methods: For this retrospective study, 122 patients who had undergone surgery from September 2016 to November 2017 with preoperative and postoperative radiographs were enrolled. Clinical and radiological outcomes were assessed before and after surgery. Results: There were no significant differences in demographics, surgery time, blood loss, medical comorbidities, or perioperative and postoperative complications between 2 groups. The recovery rate and Nurick score before and at the follow-up show no statistical significance between the 2 groups, P value. .05 (P ¼ .672) and P. .05 (P ¼ .553), respectively. The statistical analysis shows that the mean hinge fracture in the miniplate group with a cervical open angle .308 was 2.42 6 1.68 and with a ,308 open angle, 0.05 6 0.23; whereas, in the anchor group the mean hinge fracture in .308 cervical open angle was 2.227 6 2.50 and in ,308 was 0.409 6 0.503. The results revealed statistical significance between 2 implant groups, P ¼ .024 in the aspect of hinge fracture displacement and implant used. Conclusion: Laminoplasty by titanium miniplate fixation holds the laminae securely, prevents hinge fracture displacement, and promotes spinal cord expansion better than suture anchor fixation.

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“… 2 9) The basic principle of laminoplasty have included linear laminectomy on one side and making greenstick deformation of opposite side laminas. 1 9) These deformed laminas were called as hinges. The initial technique for laminoplasty had some problem such as lamina reclosure or hinge fractures (HFs).…”

Section: Introductionmentioning

confidence: 99%

“… 5 7) Nevertheless, HFs had been reported. 1 5) Some authors had been reported that HFs might be related with chronic neck pain or palsy, and had analyzed risk factors associated with HFs. 3 5 6) However, there was few studies about surgical techniques related with HFs.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Hinge Fracture Associated with Surgery Following Cervical Open-Door Laminoplasty

Lee

Chough

2018

Korean J Neurotrauma

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ObjectiveThe purpose of this study was to analyze the risk factors for hinge fracture (HF) and non-union during cervical open-door laminoplasty (CODL).MethodsWe included 25 patients who underwent CODL with available serial computed tomography scans acquired at 2 days and 1 year postoperatively. Patients' medical records and radiographic data were reviewed. Risk factors related to the surgical procedures were evaluated including the lamina angle, spinous angle, difference in the lamina angle, outer cortex location (OCL), and inner cortex location.ResultsThere were a total of 76 hinges. Of these, 44 laminae were classified as deformed hinges, and 32 were classified as fragmented hinges. Additionally, 66 laminae were healed completely, and 10 laminae were not healed by 12 months postoperatively. The OCL (odds ratio, 70.45; 95% confidence interval, 7.73–641.76) was identified as a predictor of HFs immediately following CODL. However, none of the factors we evaluated was related to hinge non-union.ConclusionA medially located hinge gutter ( >1.9 mm from the pedicle on the outer cortex) seems to be an important risk factor for HFs following CODL. However, the hinge healing status was not related to the surgical technique.

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Positive “Water Test”—An External Indicator of Base of Skull Hinge‐Ring Fracture

Cited by 7 publications

References 4 publications

Pontomedullary Laceration, a Fatal Consequence of Skull Base Ring Fracture

Pontomedullary Laceration, a Fatal Consequence of Skull Base Ring Fracture

Effect of Titanium Miniplate Fixation on Hinge Fracture and Hinge Fracture Displacement Following Cervical Open-Door Laminoplasty

Risk Factors for Hinge Fracture Associated with Surgery Following Cervical Open-Door Laminoplasty

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