桡骨头假体置换术与切开复位内固定术治疗Mason Ⅲ型桡骨头骨折的临床对比研究

Clinical study of Ⅲ Mason radial head fractures with open reduction and internal fixation compared with radial head prosthesis replacement

目的对比MasonⅢ型桡骨头骨折给予桡骨头假体置换术与切开复位内固定术的临床疗效。方法将2011年2月至2013年4月确诊并收治的148例桡骨头骨折患者按照随机数字表法分为研究组和对照组,每组74例。研究组应用桡骨头假体置换术,对照组应用切开复位中空无头加压螺钉/T型钢板内固定术。随访2年,统计对比两组的术后肘关节功能疗效及Mayo评分,统计两组并发症发生情况。结果全部患者均得到随访,无失访病例。研究组患者肘关节功能优良率为81.08%,显著优于对照组的66.22%,差异有显著性(P<0.05)。研究组其Mayo评分显著高于对照组,差异有显著性(P<0.05)。研究组并发症发生率为6.76%,显著低于对照组的25.68%,差异有显著性(P<0.05)。结论 MasonⅢ型桡骨头骨折给予桡骨头假体置换术其近期疗效优于切开复位内固定术。2年以上的远期疗效对比有待进一步研究。

Objective To study the clinical effect of Ⅲ Mason radial head fractures with open reduction and internal fixation of the radial head prosthesis replacement. Methods 148 cases of radial head fractures were randomly divided into study group and control group,each group of 74 people in April,February 2011. In the study group,the control group was performed with the use of the radial head prosthesis replacement,and the control group was performed with open reduction and internal fixation with hollow compression screws with / T. Follow up for 2 years,the clinical efficacy and Mayo score of the two groups were statistically compared with the score,and the complications occurred in the two groups. Results All patients were followed up without loss of follow- up. The good rate of elbow joint function in the study group was 81. 08%,which was significantly higher than that of the control group（ P〈0. 05）. The score of Mayo in study group was significantly higher than that in control group（ P〈0. 05）. The risk of complications in the study group was 6. 76%. The control group complication rate was 25. 68%. The incidence of complications in the study group was significantly lower than that in the control group（ P〈0. 05）. Conclusion The short- term clinical effect of III Mason radial head fracture is better than open reduction and internal fixation. For more than 2 years,the long- term effect is to be further studied.