手术治疗非严重粉碎性桡骨头骨折体会

Operative treatment of non-severely comminuted fractures of radial head

目的 介绍应用微型空心螺钉固定非严重粉碎性桡骨头骨折的方法和疗效.方法 采用Koche入路, 对27例患者行桡骨头及关节面复位,微型空心螺钉内固定治疗.按改良的Mason 分类法分类,Ⅱ型18例,Ⅲ型5例,Ⅳ型4例.23例术前行CT检查和三维重建.结果 术后随访12～18个月,平均14个月.优17例,良7例,一般3例.无一例发生骨不连、关节僵直或再脱位.结论 微型空心螺钉治疗非严重粉碎的桡骨头骨折创伤小,简便易行,疗效好.术前行CT检查和三维重建可为此类术式的选择提供可靠依据.

Objective To introduce the surgical technique and clinical effect of non-severely comminuted fractures of radial head by open reduction and internal fixation with mini - cannulated screws. Methods 27 cases were classified according to modified Mason classification and there were 18 cases of type Ⅱ,5 cases type Ⅲ, 4 cases type Ⅳ. 23 of them were checked preoperatively by spiral CT and three-dimensional evaluation. All were treated by the articular facet reduction and internal fixation with mini-cannulated screws through lateral approach. Results The patients were followed up for 12 - 18 months （mean 14 months）. The results were excellent in 17 cases, good in 7 and fair in 3. No nonunion, stiffness or re-dislocation was found. Conclusions It provides less invasion, easy manipulation and excellent results in the treatment of non-severely comminuted fractures of radial head with surgery. Spiral CT and three-dimensional evaluation preoperatively can render enough information for the selection of this operative method.