关节镜下与切开复位内固定治疗桡骨头骨折疗效比较的初步报道

Comparison of arthroscopic and open reduction with internal fixation in the treatment of radial head fractures:a preliminary report

目的探讨关节镜与开放切开复位内固定对于桡骨头骨折的治疗效果比较。方法回顾性分析2020年1月至2022年1月在本院行桡骨头骨折关节镜下或切开复位内固定的18~65岁MasonⅡ型及Ⅲ型的桡骨头骨折的病例,记录患者的年龄、性别、Mason分型、手术时间、透视次数、随访时间,以及术后功能结果[包括视觉模拟评分(visual analogue scale,VAS)、肘关节活动度以及Mayo肘关节功能评分系统(Mayo elbow performance score,MEPS)]。结果共计34例患者纳入统计,其中关节镜组11例、切开复位内固定组23例。关节镜组患者手术时间明显多于切开复位内固定组,在短期内的疼痛(VAS评分)、活动度以及MEPS评分要明显好于切开复位内固定组,两组患者在远期疼痛及功能评分无显著性差异。结论关节镜与开放术式治疗桡骨头骨折均可取得良好疗效,关节镜在桡骨头骨折的治疗上具有创伤小、伤口美观、康复速度更快等优势。

Background Radial head fractures are pretty common in clinics.Arthroscopic treatment of elbow joint trauma and complications has been widely used in clinical applications.Due to the occlusion of the annular ligament,the limitation of nail placement angle,and the risk of radial nerve injury,arthroscopic treatment of fracture of the radial head has not been widely carried out.There are few studies on comparison between arthroscopic and open reduction internal fixation for fracture of the radial head,especially for MasonⅢfracture of the radial head treated by arthroscopy.Objective To compare the effect of arthroscopy and open reduction internal fixation in treating radial head fractures.Methods A retrospective analysis was performed on cases of Mason type II and type III radial head fractures aged from 18 to 65 with arthroscopic or open reduction internal fixation of radial head fractures in one trauma center from January 2020 to January 2022.The patients'age,gender,Mason classification,operation time,fluoroscopy times,follow-up time,and postoperative functional outcomes(including pain,range of motion,and MEPS score)were recorded.Results A total of 34 patients were included in the study,including 11 patients in the arthroscopy group and 23 in the open reduction internal fixation group.The operation time of patients in the arthroscopy group was significantly longer than that in the open reduction group,and the pain(VAS score),range of motion,and Mayo elbow performance score(MEPS)score were significantly better than those in the open reduction group in the short-term survey.The two groups did not differ between the long-term VAS score and functional score.Conclusion Arthroscopy and open surgery can achieve good results in treating radial head fractures.Besides,arthroscopy has the advantages of less trauma,smaller incision,and faster rehabilitation in treating radial head fractures.