空心钛螺钉内固定治疗桡骨头骨折

Treatment of radial head fracture by internal fixation with bold canal titanium screws

目的观察切开复位、空心钛螺钉内固定治疗桡骨头骨折的临床疗效和适应证。方法2003年5月-2007年2月，对收治的18例桡骨头骨折予切开复位、空心钛螺钉内固定，男12例，女6例；年龄15～53岁，平均28．6岁。MasonⅡ型13例，MasonⅢ型3例，MasonⅣ型2例。如术中内固定牢固（旋转腕关节骨折块与主骨间无异常活动），术后尽早开始功能锻炼；如果不够牢固，术后2周开始功能锻炼。术后摄X线片了解骨折愈合情况，观察手术并发症。结果15例术后第一天即开始功能锻炼，3例术后2周开始功能锻炼，平均3个月骨折愈合，除2例MasonⅣ型外，其余患者肘关节伸屈和前臂旋转功能恢复良好，未发生桡神经深支损伤。结论MasonⅡ、Ⅲ型桡骨头骨折，应用切开复位、空心钛螺钉内固定可取得良好的临床疗效。

Objective To observe clinical results and indications of open reduction and internal fixation by bold canal titanium screws for treatment of radial head fractures. Methods From May 2003 to February 2007, 18 cases of radial head fractures were treated by open reduction and internal fixation with bold canal titanium screws, There were 12 males and 6 females at age range of 15-53 years （mean 28, 6 years）. Of all, 13 cases had Mason type Ⅱ fractures, 3 Mason type Ⅲ and 2 Mason type Ⅲ, Rehabilitation began as early as possible after operation if the internal fixation was secure ; otherwise, rehabilitation began 2 weeks after operation. Postoperative plain radiography was made to observe fracture healing and complications. Results After operation, the rehabilitation was done at the first day in 15 cases and at 2 weeks in 3, with mean fracture healing time of 3 months. Function of elbows and rotation of forearms were excellent except for 2 cases with Mason Ⅳ fractures. No deep branch of radial nerve injury occurred. Conclusion Open reduction and internal fixation with bold titanium canal screws can attain satisfactory clinical results in treatment of Mason type Ⅱ and Mason type Ⅲ radial head fractures.