交叉螺钉固定法治疗桡骨颈骨折

Cross-screws fixation for radial neck fractures

【摘要】目的探讨交叉螺钉固定技术对明显移位的桡骨颈骨折的治疗效果。方法回顾性分析2009年10月至2012年8月接受切开复位交叉螺钉固定术治疗的29例Masonlib型明显移位的桡骨颈骨折患者资料，男18例，女11例；年龄18～56岁（平均37．2岁）；左侧16例，右侧13例。受伤至手术时间为3～72h（平均33．9h）。所有骨折的移位〉2mm或成角〉30°。术后1年根据Broberg＆Morrev评分标准评定肘关节功能。结果29例患者术后获12—29个月（平均16个月）随访。所有患者骨折均在3个月内愈合，愈合时间为4～12周，平均10．6周。术后1年Broberg＆Morrey评分：优15例，良10例，一般3例，差1例，优良率为86．2％。所有患者均未发生伤口感染、神经损伤、骨折移位及内固定失效等并发症。无一例患者因局部不适而要求取出内固定物。结论交叉螺钉固定桡骨颈骨折可以获得满意的治疗效果。

Objective To evaluate the cross-screws fixation for displaced radial neck fractures. Methods A total of 29 patients with displaced radial neck fracture （Mason type I/b） were treated by open reduction and cross-screws fixation at our department from October 2009 to August 2012. They were 18 males and 11 females, aged from 18 to 56 years （average, 37.2 years）. The fractures affected 16 left and 13 right sides. The time from injury to operation was from 3 to 72 hours, with an average of 33.9 hours. All fractures were displaced by more than 2 mm or angulated by more than 30~, and caused by simple falling. The elbow function was evaluated by the Broberg ＆ Morrey scoring system at one year postoperation. Results All the 29 patients were followed up for an average of 16 months （range, from 12 to 29 months）. All fractures healed within 3 months, ranging from 4 to 12 weeks （mean, 10. 6 weeks）. By the Broberg ＆ Morrey scores at one year postoperation, 15 patients were rated as excellent, 10 as good, 3 as fair and one as poor, giving an excellent to good rate of 86, 2%. No wound infection, neural injury, fracture displacement or fixation failure occurred. No implants were removed due to local uneasiness. Conclusion Cross-screws fixation can achieve satisfactory outcomes for radial neck fractures.