Herbert加压螺钉对老年桡骨头骨折的临床疗效分析

Clinical curative effect analysis of Herbert compression screw for elderly radial head fracture

目的探究Herbert加压螺钉对老年桡骨头骨折的临床疗效。方法对2009年9月—2010年8月在我院进行治疗的56例桡骨头骨折老年患者进行切开复位Herbert加压螺钉治疗,观察该方法治疗的固定成功率和患者肘关节功能恢复情况。结果 MasonⅡ型患者优良率为90.3%,无不良患者;而MasonⅢ型为72.0%,2例患者疗效判定为不良。MasonⅡ型患者治疗后效果优于MasonⅢ型;所有患者治疗后肘关节活动范围均较入院时有所上升,而MasonⅡ型在肘关节屈曲、伸直及旋前、旋后方面改善程度均优于MasonⅢ型患者。患者伤口愈合时间为8～10周,MasonⅡ型患者出现1例关节异位骨化,经对症治疗后病情得到控制;MasonⅢ型患者未出现明显不良反应。不同分型的患者出现不良反应的情况无统计学差异。结论 Herbert加压螺钉对老年桡骨头骨折具有良好的疗效及安全性,但对MasonⅢ型骨折的治疗仍需术后石膏外固定辅助。

Objective To explore the curative effect of Herbert compression screw on elderly patients with radial head fractures.Methods During September 2009 to August 2010,56 elderly patients with radial head fracture were admitted in our hospital and received Herbert compression screw for treatment.The fixed success rate and elbow joint function recovery were observed. Results The excellent and good rate in Mason Ⅱ patients was 90.3%,no patients with poor curative effect,and in Mason Ⅲ patients was 72%,the effects were judged to be poor in 2 patients.Effect in Mason Ⅱpatients after the treatment is better than that of Mason Ⅲ;elbow motion ranges in patients after treatment were improved,but Mason Ⅱ patients in elbow flexion,extension and pronation,supination were superior to Mason Ⅲ patients.The wound healing time was 8-10 weeks,1 cases of heterotopic ossification occurred in Mason Ⅱ patients,after the symptomatic treatment,the disease was under control;there were no significant adverse reaction in Mason Ⅲ patients.The difference of adverse reactions in different types showed no statistical significance. Conclusion Herbert compression screw for elderly radial head fracture has good efficacy and safety,but for Mason Ⅲ fracture treatment still needs a postoperative plaster external fixation support.