Mason Ⅰ、Ⅱ型桡骨小头骨折非手术治疗的比较研究

Mason Type Ⅰ and Type Ⅱ Radial Head Fractures:A Comparative Study on Non-operative Treatment

目的评价并比较对MasonⅠ、Ⅱ型桡骨小头骨折应用功能治疗方法(早期肘关节活动)与传统石膏固定方法的治疗效果,以及对肘关节功能的影响。方法将60例MasonⅠ、Ⅱ型桡骨小头骨折患者随机分成2组:①石膏固定组(30例):长臂石膏固定4周后拆除,开始功能锻炼;②功能治疗组(30例):骨折后不用外固定或短期内应用(固定时间3～10d),早期进行关节活动。随访时间12～36个月,平均20个月。按照Broberg和Morrey的评定标准对2组肘关节进行功能评分[1]。结果全部病例获得随访,肘关节功能评分:石膏固定组平均为89.8分,极好18例,好8例,一般4例,优良率达86.7%。功能治疗组平均为96.5分,极好23例,好7例,优良率达100%;功能治疗组优良率优于石膏固定组(χ2=4.29,P<0.01)。结论早期肘关节活动可显著提高MasonⅠ、Ⅱ型桡骨小头骨折后肘关节的功能。

[ Objective ] To evaluate and compare the efficacy of functional therapy and conventional plaster immobilization for Mason type Ⅰ and type Ⅱ radial head fractures, and the influence of elbow joint function. [ Methods]60 cases of Mason type Ⅰ and type Ⅱradial head fractures were randomly divided into two groups. ① the plaster immobilization group （30 cases ） ： functional exercise was carried out after 4 weeks of long arm cast immobilization;② the functional therapy group （ 30 cases） ： early elbow motion was performed without immobilization or with short-term immobilization （ 3 - 10 days）. The average follow-up time was 20 months （ 12 - 36 months ）. Elbow function was assessed according to Broberg and Morrey elbow score. [ Results ] All patients were followed up. The average elbow function score of the plaster immobihzation group was 89.8, the good rate was 86.7% with 18 excellent cases, 8 good cases and 4 common cases. The average elbow function score of the functional therapy group was 96.5, the good rate was 100% with 23 excellent cases and 7 good cases. The effect of the functional therapy group was significantly better than that of the immobilization group （ X^2 = 4.29, P 〈 0.01 ）. [ Conclusion ] The early elbow motion can remarkably improve elbow function of Mason type I and type II radial head fractures.