桡骨头粉碎性骨折切除和内固定对比

COMPARISON OF RESECTION AND LNTERNAL FIXATION SURGICAL TECHNIQUE TO TREAT COMMINUTED FRACTURES OF THE RADIAL HEAD

目的:过去桡骨头粉碎性骨折进行切开复位内固定的效果常常不是十分理想,因此,常进行桡骨头切除,近几年随着内固定材料的进步,越来越多的桡骨小头粉碎性骨折采用精细内固定技术治疗,取得很好疗效。在本研究中,我们对桡骨头粉碎性骨折采用切除桡骨头与切开复位内固定的结果进行了对比。方法:本研究中共30例Mason-Ⅲ型桡骨头骨折,分为两组,组1共16例采用桡骨头切除治疗,组2共14例采用切开复位内固定,随访时间分别为2a～8a,平均5年8个月。随访结果根据疼痛、活动、、肌力,X线的表现等进行评估。总体结果采用Broberg和Morrey的功能等级评分和Mayo肘关节功能评估指数(MEPI)进行评定。结果:组1的Broberg和Morrey的功能等级评分平均为82.1分,而组2为90.5分(p=0.0033),Mayo肘关节功能评估指数(MEPI))为组1为86.4分,组2为94.5分(p=0.0032)。结论:粉碎性桡骨头骨折通过切开复位及精细内固定可以获得满意的复位及稳定,术后其力量和总体功能结果均优于桡骨头切除。

Objective：In the past, the effect of treatment of open reduction and internal fixation for the radial head fracture had been not very good. Therefore, the radial head excision was often taken. As internal fixation material advances in recent years, more and more radial head fractures have been in the precise fixation treatment, and achieved good results. In this study, we used radial head excision and open reduction and internal fixation for the radial head fracture, and the results were compared. Methods： In this study, 30 cases Mason -Ⅲ type of radial head fractures were divided into two groups. Group 1 （ 16 patients ） had radial head resection, Group 2（ 14 patients ） had open reduction and internal fixation. We followed up for 2 to 8 years （ average of 5 years and 8 months）. According to pain, activity, muscle strength, X - ray to assess the follow - up results. The results were assessed by Broberg and Morrey functional rating score and the Mayo elbow function assessment index （MEPI）. Result：The Broberg and Morrey functional rating score of Group 1 was 82.1 in average, while Group 2 was 90.5 in average （p = 0.0033 ）, Mayo elbow function assessment index （MEPI）） of Group 1 was 86.4, 94.5 points for the group 2 （p = 0.0032）. Conclusion： Comminuted radial head fractures by open reduction and internal fixation can be refined to obtain a satisfactory reduction and stability, strength and overall function post - operatively were better than the radial head resection