{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:41:39Z","timestamp":1791499299039,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and validate the efficacy of a 3D\u2010printed screw\u2010rod auxiliary system for unstable atlas fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This research is a retrospective analysis, and a total of 14 patients, including 11 males and three females, were enrolled in our hospital from January 2017 to March 2019 who underwent occipitocervical fusion assisted by the 3D\u2010printed screw\u2010rod auxiliary system were reviewed, and with an average age of 53.21\u2009\u00b1\u200914.81\u2009years, an average body mass index (BMI) of 23.61\u2009\u00b1\u20091.93 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . The operation time, blood loss and radiation times during the operation were recorded. The maximum fracture displacement values of pre\u2010 and post\u2010operation were measured based on CT imaging. All screw grades were evaluated after surgery. The occipital\u2010cervical 2 (O\u2010C\n                      <jats:sub>2<\/jats:sub>\n                      ) angle and occipitocervical inclination (OCI) angle of pre\u2010operation, post\u2010operation and the last following\u2010up were measured. The dysphagia scale 3\u2009months after surgery and at the last follow\u2010up, the Neck Disability Index (NDI) 3\u2009months after surgery and at the last follow\u2010up were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All patients were completed the surgery successfully. There was no patient with severe dysphagia or aggravation of nerve injury. The follow\u2010up was from 12 to 14\u2009months, and with an average of 12.5\u2009months. The average surgery time, average blood loss and average radiation times for the 14 patients were 112.14 min, 171.43 mL and 5.07 times, respectively. There was a significant difference in maximum fracture displacement between pre\u2010 and post\u2010operation values (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). A total of 56 screws were inserted in 14 patients, among them, three screws were classified as grade 1, and the other screws were classified as grade 0. There was a significant difference in the O\u2010C\n                      <jats:sub>2<\/jats:sub>\n                      between pre\u2010operation and 3\u2009days after operation (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002); There was a significant difference in OCI angles between pre\u2010operation and 3\u2009days after operation (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05); there was no significant difference in the O\u2010C\n                      <jats:sub>2<\/jats:sub>\n                      or OCI angle between 3\u2009days after the operation and the last follow\u2010up (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.079;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.201). The dysphagia scales of two patients were assessed as mild at 3\u2009months after surgery, and the others were assessed as normal at 3\u2009months after surgery. All patients' dysphagia scores returned to normal at the last follow\u2010up. The average NDI and average neck Visual Analogue Scale (VAS) scores at the last follow\u2010up were 2.53 and 8.41, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It can objectively restore the OCI to normal with few post\u2010operative complications under the assistance of a screw\u2010rod auxiliary system to perform occipitocervical fusion for unstable atlas fractures and atlantooccipital joint instability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.13015","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T09:27:51Z","timestamp":1617787671000},"page":"1006-1015","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<scp>3D\u2010Printed Screw\u2010Rod<\/scp>\n                    Auxiliary System for Unstable Atlas Fractures: A Retrospective Analysis"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7215-1460","authenticated-orcid":false,"given":"Chao","family":"Wu","sequence":"first","affiliation":[{"name":"Orthopaedics Center, Zigong Fourth People's Hospital  Zigong China"},{"name":"Digital Medical Center, Zigong Fourth People's Hospital  Zigong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010yan","family":"Deng","sequence":"additional","affiliation":[{"name":"Digital Medical Center, Zigong Fourth People's Hospital  Zigong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[{"name":"Orthopaedics Center, Zigong Fourth People's Hospital  Zigong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u2010fang","family":"Zeng","sequence":"additional","affiliation":[{"name":"Digital Medical Center, Zigong Fourth People's Hospital  Zigong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai\u2010gang","family":"Hu","sequence":"additional","affiliation":[{"name":"Orthopaedics Center, Zigong Fourth People's Hospital  Zigong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan\u2010fang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Health Management Center, Zigong Fourth People's Hospital  Zigong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Wei","sequence":"additional","affiliation":[{"name":"Orthopaedics Center, Zigong Fourth People's Hospital  Zigong 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