钢丝环形捆扎加微型钢板内固定治疗桡骨头粉碎性骨折

Treatment of comminuted radial head fracture by wire ring-binding and micro-plate internal fixation

目的探究切开复位钢丝环形捆扎加微型钢板内固定治疗桡骨头粉碎性骨折的临床疗效。方法回顾性分析2010年1月至2017年6月攀枝花市仁和区人民医院收治的25例桡骨头粉碎性骨折患者的临床资料,患者均行切开复位钢丝环形捆扎加微型钢板内固定治疗。记录骨折愈合时间及并发症发生情况,采用Mayo功能评分评估患者肘关节功能。结果患者切口均Ⅰ期愈合。骨折愈合时间3~6个月(平均4个月)。术中无神经、血管损伤,术后无切口感染及异位骨化并发症发生。随访时间6~42个月,平均随访时间28个月。末次随访时肘关节屈伸范围(120±5)°、前臂旋转范围(132±6)°;Mayo肘关节功能评分(90±8)分,优11例、良14例,优良率100%。结论钢丝环形捆扎加微型钢板内固定可使骨折获得良好复位及坚强固定,允许患者术后早期进行肘关节功能锻炼,避免关节僵硬,是一种治疗桡骨头粉碎性骨折的有效方法。

Objective To explore the effects of wire ring-binding and micro-plate internal fixation in the treatment of comminuted radial head fracture. Methods Twenty-five patients with comminuted radial head fracture were treated by open reduction, wire ring-binding and micro-plate internal fixation from January 2010 to June 2017 in Panzhihua Renhe People＇s Hospital, and their clinical data were retrospectively analyzed. Fracture healing time and complications were recorded, and the elbow function was evaluated by Mayo function scoring.Results All incisions obtained primary healing. Fracture healing time was 3 to 6 months, with the average of 4 months. No further nerve or vessel injuries were found during the surgery, also, there were no cases of surgical site infection or heterotopic ossification after the surgery. The follow-up time was 6 to 42 months（average, 28 months）. At the last follow-up, the range of extension and flexion of the elbow was（120 ± 5）°, and the range of pronation and supination of the forearm was（132 ± 6）°; Mayo function score was（90 ± 8） points, with the excellent and good rate of 100%（excellent in 11 and good in 14 cases）. Conclusion For comminuted radial head fracture, wire ring-binding and micro-plate internal fixation is an effective surgical procedure which can achieve good reduction, offer stable fixation, make earlier elbow function rehabilitation possibly and avoid joint stiffness.