应用on-table重建技术联合微型接骨板内固定治疗Mason Ⅲ、Ⅳ型桡骨头骨折

Application of on-table reconstruction combined with mini-plate internal fixation for Mason Type-Ⅲ and Ⅳ fractures of the radial head

目的探讨应用on-table重建技术联合微型接骨板内固定治疗MasonmⅢ、Ⅳ型桡骨头骨折的临床疗效。方法桡骨头骨折患者15例，骨折按改良Mason分型：Ⅲ型13例，Ⅳ型2例，采用on-table重建技术联合微型接骨板内固定治疗，并同时修复侧副韧带复合体。末次随访时采用Mayo评分评估术后肘关节功能恢复程度，DASH问卷调查表行术后肘关节功能自我评价。结果所有病例获得12—25个月随访，平均18个月。骨折均获骨性愈合，愈合时间为12—16周，平均14周。末次随访时Mayo肘关节功能评分为（81．5±12．7）分，其中优6例，良6例，可1例，差2例，优良率为80．0％。DASH评分值为（14±7）分。术后2例发生异位骨化，1例发生创伤性关节炎。结论应用on-table重建技术联合微型接骨板内固定治疗MasonⅢ、Ⅳ型桡骨头骨折可获得满意的复位及固定效果，临床疗效良好。

Objective To explore the clinical effect of on-table reconstruction combined with mini-plate internal fixation for the treatment of Mason Type-Ⅲ and IV fractures of the radial head. Methotis Fifteen cases of radial head fractures were treated with on-table reconstruction combined with miniplate internal fixation, and the injured collateral ligament complexes were repaired. According to the modi-fied Mason classification,there were 13 cases of Mason Type-Ⅲ fractures and 2 cases of Mason Type-Ⅳ fractures. At the final follow-up, the functional outcomes were evaluated by the Mayo score, and the self-as- sessments of elbow joint function were evaluated by the DASH questionnaires. Results All cases were followed up for 18 months （range, 12 -25 months）. All the fractures healed, and the mean healing time was 14 weeks （range, 12 - 16 weeks ）. At the final follow - up, the Mayo elbow function score was （81.5 ± 12.7） ,and the results were excellent in 6 cases,good in 6 cases,fair in 1 case,and poor in 2 cases,with a good and excellent rate of 80.0%. The DASH score was （14 ± 7）. There were two cases of heterotopic ossification and one case of traumatic arthritis after surgery. Conclusion The application of on-table re-construction combined with mini-plate internal fixation for Mason type-Ⅲ and Ⅳ fractures of the radial head can obtain satisfactory restoration and fixation, and the clinical effect is good.