肘关节镜下应用Harbert钉治疗MasonⅡ型桡骨小头骨折

Arthroscopic Treatment of Type MasonⅡ Radial Head Fracture with Herbert Screw Fixation

目的：探讨肘关节镜下应用Harbert钉治疗MasonⅡ型桡骨小头骨折的方法和临床疗效。方法：2009年10A～2013年4月，采用肘关节镜下应用Harbert钉内固定治疗MasonⅡ型桡骨小头骨折26例，术后早期康复训练。术后定期随访复查X线，比较患侧与健侧屈曲、旋转活动度，采用Mayo评分评价肘关节功能。结果：26例患者切口均Ⅰ期愈合，术后3个月复查X线，均显示骨折线消失，骨折愈合。患侧屈伸活动度（138．0±8．1）°，健侧（142．0±4．6）°，两者差异无统计学意义（P〉0．05）：患侧旋转活动厦（142．8±10．5）°，健侧（145．5±3．8）°，两者差异无统计学意义（P〉0．05）。患侧肘关节Mayo评分平均92．7分，其中优22例，良4例。26例患者主观满意度良好。结论：肘关节镜下应用Harbert钉治疗MasonⅡ型桡骨小头骨折创伤小，固定可靠，康复快，并发症少．值得推广。

Objective To investigate arthroscopic treatment of type Mason Ⅱ radial head fracture with Herbert screw fixation method and its clinical outcome. Methods 26 cases of type Mason Ⅱ radial head fracture were treated with arthroscopy-assisted reduction,Herbert screw fixation and early postoperative rehabilitation from October of 2009 to April of 2013 in our hospital. All patients were followed up and the flexion-extension ROM and rotation of the injured elbow were compared with that of the contralateral side. Elbow function was evaluated with Mayo Elbow Performance Score （MEPS）. Results Flexion- extension ROM of injured elbows is（138.0±8.1）°and of contralateral side is（142.0±4.6）° ,rotation ROM of injured elbows is （142.8 ±10.5）° and contralateral side is （145.5±3.8）° There is no significant difference in elbow function between injured elbow and contralateral side （P 〉 0.05）. Average MEPS of the injured elbow is 92.7. Elbow functions are excellent in 22 cases and good in 4. Conclusion Arthroscopy-assisted reduction and Herbert screw fixation is an effective treatment for type Mason Ⅱ radial head fractures with less trauma, sturdy fixation, less complication and rapid postoperative recovery.