摘要
目的探讨切开复位内固定治疗桡骨头骨折的临床疗效。方法采用切开复位内固定治疗38例桡骨头骨折患者,其中18例采用Herbert螺钉治疗,16例采用微型掌指骨钢板治疗,4例采用微型掌指骨钢板联合Herbert螺钉治疗。记录骨折复位情况、骨痂形成时间、骨折愈合时间、肘关节活动度。采用Broberg-Morrey评分评价肘关节功能情况。结果患者均获得随访,时间3~15个月。切口均一期愈合。33例骨折对位对线良好,关节面平整,桡骨头高度恢复,达解剖复位。5例骨折复位不良:3例(MasonⅡ型1例、Ⅲ型2例)桡骨头有轻度塌陷、歪戴帽征;2例(MasonⅢ型)桡骨颈短缩,桡骨头高度未完全恢复,出现外翻轻度不稳。骨痂形成时间5~10(7.05±1.12)周,骨折愈合时间9~16(13.15±2.10)周。末次随访时,Broberg-Morrey肘关节功能评分为52~98(85.8±7.6)分,其中优15例,良16例,可3例,差4例,优良率81.6%(31/38);肘关节屈曲100°~140°(125.2°±3.2°)、伸直10°~80°(30.2°±3.1°),前臂旋前10°~90°(60.2°±4.1°)、旋后15°~90°(55.0°±6.1°)。结论切开复位内固定治疗桡骨头骨折方法简单、固定可靠,有利于患者早期进行前臂旋转活动及肘关节屈伸训练,临床疗效满意。
Objective To investigate the clinical effect of open reduction and internal fixation in the treatment of radial head fractures.Methods The 38 cases of radial head fractures were treated with open reduction and internal fixation,including 18 cases of Herbert screws internal fixation,16 cases of mini metacarpophalangeal plate internal fixation,and 4 cases of mini metacarpophalangeal plate combined with Herbert screws.Fracture reduction,callus formation time,fracture healing time and elbow range of motion(ROM)were recorded.The Broberg-Morrey score was used to evaluate elbow function.Results All patients were followed up for 3~15 months.All incisions healed in one-stage.The 33 cases had good alignment,with smooth articular surface,good recovery of the radial head and anatomic reduction.Anatomical reduction of fracture line was not achieved in 5 cases,including 3 cases(1 case of Mason type-Ⅱand 2 cases of Mason type-Ⅲ)with mild radial head collapse and crooked cap sign,and 2 cases(Mason type-Ⅲ)with radial neck shortening,incomplete recovery of radial head height and mild valgus instability.The callus formation time was 5~10(7.05±1.12)weeks,and the fracture healing time was 9~16(13.15±2.10)weeks.At the last follow-up,Broberg-Morrey elbow function scores were 52~98(85.8±7.6)points,of which 15 cases were excellent,16 cases were good,3 cases fair,and 4 cases poor,with an excellent and good rate of 81.6%(31/38).Elbow range of motion:flexion was 100°~140°(125.2°±3.2°),extension was 10°~80°(30.2°±3.1°),forearm pronation 10°~90°(60.2°±4.1°),supination 15°~90°(55.0°±6.1°).Conclusions The method of open reduction and internal fixation for the treatment of radial head fracture is simple and reliable,which is conducive to early forearm rotation and elbow flexion and extension training.The clinical effect was satisfactory.
作者
梅正峰
毛天明
杨成珍
安尼卡尔•艾斯卡尔
梁勋亮
平立原
雷文涛
MEI Zheng-feng;MAO Tian-ming;YANG Cheng-zhen;Annikaer Aisikaer;LIANG Xun-liang;PING Li-yuan;LEI Wen-tao(Dept of Orthopaedics,the Third People′s Hospital of Hangzhou,Hangzhou,Zhejiang 310000,China;Dept of Orthopaedics,the People′s Hospital of Aksu City,Aksu,Xinjiang 843000,China)
出处
《临床骨科杂志》
2023年第3期370-373,共4页
Journal of Clinical Orthopaedics
