不同入路微型空芯螺钉内固定术治疗桡骨头骨折的疗效对照研究

Comparative study the efficacy of different access on miniature hollow screw fixation in the treatment of radial head fracture

目的探讨不同入路行微型空心螺钉内固定术治疗桡骨头骨折的临床疗效。方法桡骨头骨折病人67例,均行微型空芯螺钉内固定术,将67例病人分为两组,A组34例,经肘前侧入路;B组33例,经肘外侧入路。比较两组病人肘关节功能恢复情况、手术时间、并发症等。结果A组的手术时间[(37.2±3.4)min]、肘关节功能恢复时间[(245.2±31.2)d]均短于B组[(42.5±2.8)min,(245.2±31.2)d],骨折显露时间[(20.8±2.7)min]明显长于B组[(11.5±1.3)min],两组比较差异有统计学意义(P<0.05)。两组骨折愈合时间[(10.2±2.1)m比(10.6±1.7)m]比较差异无统计学意义(P>0.05)。A组术后半年肘关节屈伸弧、前臂旋前、前臂旋后活动度均高于B组,手术治疗优良率(85.29%比69.70%)高于B组,术后并发症发生率低于B组(P<0.05)。结论与肘外侧入路比较,经肘前侧入路行微型空芯螺钉内固定术治疗桡骨头骨折的手术时间更短,对周围组织的损伤更轻,术后肘关节功能恢复更好。

Objective To explore the clinical efficacy of different access on miniature hollow screw fixation in the treatment of radial head fracture. Methods 67 patients with radial head fractures were treated with mini-hollow screw fixation as study objects. Them were divided into two groups according to the random number table method：group A（ n = 34）chose the elbow anterior approach, and gourp B （n = 33） chose the elbow lateral approach. Then compared the elbow function recovery, operation time, compli- cations and so on of two groups. Results The operation time [ （37.2 ±3.4） min ] and elbow joint func- tion recovery time[ （245.2 ±31.2）d] in group A were significantly shorter than group B[ （42.5 ±2.8） min, （ 245.2 ±31.2 ） d ], and the fracture exposure time [ （ 20.8 ±2.7 ） min] was significantly longer than that in group B [ （ 11.5 ±1.3 ） min] （ P 〈 0.05 ）. There was no significant difference in fracture healing time [ （ 10.2 ±2.1 ） mvs （ 10.6 ±1.7 ） m ] between the two groups （ P 〉 0.05 ）. The flexion and extension arcs ,forearm pronation and forearm pronation activities of the elbow in group A after treatment 6 month were significantly higher than group B,the excellent and good rate of operation in group A（85.29% ）was significantly higher than group B（69.70% ）, and the incidence of postoperative complications in group A was significantly lower（P 〈 0.05 ）. Conclusion Compared with the lateral approach of the elbow, the treatment of radial head fractures through the anterior approach of the elbow has shorter operation time, less damage to the surrounding tissues and better recovery of elbow function.