微型锁定钢板结合植骨治疗桡骨小头MasonⅢ型骨折的疗效分析

Treatment of radial head Mason type Ⅲ fracture with mini locking plate combined with bone graft

目的探讨应用微型锁定钢板+植骨治疗MasonⅢ型桡骨小头骨折的临床效果。方法纳入2008年3月至2013年12月本院收治的29例桡骨小头骨折病人,男21例,女8例;年龄为19~56岁,平均35.0岁。均为闭合性骨折,其中11例骨缺损严重。X线和CT检查显示为MasonⅢ型骨折。采用在臂丛神经阻滞麻醉下行切开复位微型锁定钢板内固定联合植骨的手术方法,并进行统一的早期康复锻炼。采用Morrey肘关节功能评分标准进行评价。结果病人均获得随访,随访时间为6~18个月。均达到解剖复位,牢固固定,骨折愈合好。术后6个月Morrey评估标准评分:优25例,良3例,差1例,优良率为96.6%。结论切开复位微型锁定钢板+植骨治疗桡骨小头MasonⅢ型骨折可有效保留桡骨小头固有解剖结构及功能,固定坚强可靠,骨折复位满意,值得临床推广运用。

Objective To investigate the clinical application and evaluate the effects of miniaturelocking plate combined with bone graft in the treatment of Mason typeⅢradial head fractures.Methods From March2008to December2013,a total of29patients suffering Mason typeⅢradial head fractures and receiving miniature locking plate combined with bone graftwere chosen in our department.There were21cases of male patients and8cases of female patients.The ages were from19to56years with an average age of35.0years old.All patients had closed bone fractures and11cases of them were combined with the bone defects.All the cases had a definite diagnosis of Mason typeⅢradial head fractures by the X-ray and CT examinations before operations.During the operations all the patients were given the same treatment procedures of the miniature locking plate combined with bone graft.The early rehabilitation training was conducted in all patients after operations.The functions of elbow joint were accessed by the elbow function rating system of Morrey.Results After6?18months of follow-up,it was found that all the bone fractures had the anatomic reductions,reliable fixations and complete bone unions.And the excellent?good rate of the function of elbow joint was96.6%accessed by the Morrey rating system,in which there were25cases of excellent efficacy,3cases of goodand1case of bad.Conclusion The combination of miniature locking plate and bone graft in the treatment of Mason typeⅢradial head fractures had the excellent effects of fracture fixations,reductions and unions.It could effectively retain the anatomic structure and function of capitulum radii and helpfully do good to the early functional exercises.This method was worth of wider clinical applications.