摘要
目的根据桡骨小头骨折的不同类型，分别采用切开复位内固定、桡骨头切除、人工桡骨小头置换等方法治疗桡骨小头骨折，并分析其疗效，总结适宜的桡骨小头骨折治疗策略。方法回顾分析1999年11月-2008年5月收治的48例桡骨头骨折（47例患者）的临床资料，其中保守治疗9例（均为MasonⅠ型）；切开复位内固定治疗28例（MasonⅠ型1例，MasonⅡ型14例，Masonm型13例）；桡骨小头切除8例（MasonⅢ型3例，MasonIV型5例）；桡骨小头置换3例（MasonⅣ型）。结果平均随访2．6年（1—4．4年），2例桡骨小头置换分别随访6个月和3个月。按照Mayo肘关节功能评分评价其疗效，保守治疗优良率为8／9，切开复位内固定优良率为82％（23／28），桡骨头切除优良率为6／8，人工假体置换优良率为3／3。结论桡骨小头骨折应该尽量达到解剖复位以方便早期的功能锻炼。MasonⅠ型骨折可以采用保守治疗；MasonⅡ型、MasonⅢ型和部分MasonIV型骨折可以采用切开复位内固定治疗；部分MasonⅣ型骨折无法通过内固定达到稳定固定的，可以选择单纯桡骨头切除或人工桡骨头假体置换。
Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Methods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our department from November 1999 to May 2008. Among them, nine patients were treated conservatively （all type Mason Ⅰ fractures） , 28 treated with open reduction and internal fixation （ one patient with type Mason Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ） , eight with removal of radial head （ three patients with type Mason Ⅲ fractures and five with type Ⅳ ） and three with artificial joint replacement （all type Mason Ⅳfractures ）. Results All patients were followed up for average 2.8 years （1-4.4 years）. Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% （23/28） in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are alternative for parte of type Mason IV fractures that can not attain stable fixation through open reduction and internal fixation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2009年第6期535-538,共4页
Chinese Journal of Trauma
基金
基金项目：国家“十一五”科技支撑计划资助项目（2007BA104BOO）
关键词
桡骨骨折
骨折固定术
内
关节成形术
置换
桡骨小头
Radius fractures
Fracture fixation, internal
Arthroplasty, replacement
Radial head
