切开复位钢板内固定治疗桡骨头骨折

Open reduction and plate internal fixation for treatment of radial head fractures

目的探讨切开复位钢板内固定治疗桡骨头骨折的临床效果。方法将41例MasonⅢ、Ⅳ型桡骨头骨折患者按照治疗方式的不同分为对照组(采用桡骨头置换术治疗,20例)和观察组(采用钢板内固定术治疗,21例)。比较两组术中出血量、手术时间、住院时间、住院费用、疼痛VAS评分、Mayo评分及优良率、肘关节活动度。结果患者均获得随访,时间8~20(13.8±4.3)个月。术中出血量、手术时间、住院时间、住院费用两组比较差异均无统计学意义(P>0.05)。术后不同时间点VAS评分、Mayo评分两组比较差异均无统计学意义(P>0.05)。末次随访时Mayo评分优良率、肘关节活动度两组比较差异均无统计学意义(P>0.05)。结论与桡骨头置换术比较,切开复位钢板内固定运用降维复位技术治疗MasonⅢ、Ⅳ型桡骨头骨折临床疗效满意,具有患者易接受、并发症少等优势,可作为MasonⅢ、Ⅳ型桡骨头骨折治疗的选择。

Objective To investigate the clinical effect of open reduction and plate internal fixation for treatment of radial head fractures.Methods The 41 patients with Mason typeⅢ,Ⅳradial head fractures were divided into the control group(20 cases were adopted with radial head replacement)and the observation group(21 patients were treated with plate internal fixation),according to the different treatment methods.The following data were compared between the two groups,including the intraoperative blood loss,operation time,hospitalization time,and hospitalization cost,pain VAS and Mayo scores and its excellent-good rate,the activity of elbow joint.Results All patients were followed up for 8~20(13.8±4.3)months.There were no significant differences in intraoperative blood loss,operative time,hospitalization time,and hospitalization costs between the two groups(P>0.05).There were no statistical differences in VAS,Mayo scores at different time points between two groups(P>0.05).At the last follow-up,there were not significant differences in the excellent-good rate of Mayo scores and the activity of elbow joint between the two groups(P>0.05).Conclusions For treatment of Mason typeⅢ,Ⅳradial head fractures,the clinical curative effect of open reduction and plate internal fixation using dimension reduction technique is satisfactory,compared with radial head replacement,which has the advantages of easy absorption,fewer complications,and can be used as treatment option of Mason typeⅢ,Ⅳradial head fractures.