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目的：探讨新鲜ⅡA型齿突骨折的治疗方法的选择。方法2006年1月—2012年12月，空军总医院骨科收治新鲜ⅡA型齿突骨折13例，其中5例采用Halo-vest支架外固定治疗（外固定组），8例采用前路齿突螺钉内固定治疗（内固定组）。以疼痛视觉模拟量表（VAS）评分、SF-36评分、并发症发生率、融合率作为指标评价疗效。结果术后2组患者VAS评分较术前均有不同程度降低。内固定组SF-36评分明显高于外固定组。5例外固定组患者术后12周时3例骨折愈合，2例未融合者延长佩戴时间，末次随访时全部骨折愈合。8例内固定组患者术后12周时全部骨折愈合。外固定组发生钉道感染1例，螺钉松动2例，骨折畸形愈合1例。内固定组发生螺钉退出1例。结论前路齿突螺钉内固定适用于治疗无手术禁忌证的ⅡA型齿突骨折，Halo-vest支架适用于有前路齿突螺钉手术禁忌证的ⅡA型骨折。“,”Objective To explore the surgical treatment strategies of fresh typeⅡA odontoid fractures.Methods According to Grauer’s classification,13 patients with fresh typeⅡA odontoid fractures admitted toAir Force General Hospital of PLA hospital during January 2006 to December 2012 were followed up. Five patients were treated with Halo-vest orthosis (external fixation group),and 8 with anterior odontoid screw fixation(internal fixation group). Neck pain visual analogue scale(VAS) score,SF-36 score,complications and fusion rates were employed to evaluate the therapeutic effect in each group. Results The VAS scores decreased in each group after operation. SF-36 score of internal fixation group was higher than that of external fixation group. Three patients in external fixation group obtained fracture healing at postoperative 12 weeks and 2 non-fusioned patients obtained a final fracture healing after prolonged wear of Halo-vest orthosis at the final follow up. All patients in internal fixation group obtained fracture healing at postoperative 12 weeks. Trajectory infection in 1 patients,screw loosening in 2 patients,and malunion in 1 patient in the external fixation group;Screw pullout in 1 patient in internal fixation group.Conclusion Anterior odontoid screw fixation is suitable for typeⅡA odontoid fracture patients without surgical contraindication. Halo-vest orthosis is suitable for the typeⅡA odontoid fracture patient with surgical contraindication of anterior odontoid screw fixation.