T形钢板联合Herbert螺钉内固定术治疗MasonⅢ型桡骨头骨折疗效及对围术期指标肘关节功能评分和并发症的影响

Efficacy of T-Plate Combined with Herbert Screw Internal Fixation for MasonⅢRadial Head Fractures and Its Influence on Perioperative Indicators Elbow Function Score and Complications

目的:探究T形钢板联合Herbert螺钉内固定术治疗MasonⅢ型桡骨头骨折疗效及对围术期指标、肘关节功能评分和并发症的影响。方法:随机选取我院118例MasonⅢ型桡骨头骨折患者为研究对象,按照简单随机法分为观察组和对照组,对照组(n=58)行T型钢板固定术治疗,观察组(n=60)行T形钢板联合Herbert螺钉内固定术治疗,比较两组围手术期指标、疼痛评分、术后并发症及肘关节功能。结果:观察组临床有效率为93.33%,对照组为77.59%,两组对比差异有统计学意义(P<0.05);观察组手术时间、术后开始运动时间均显著低于对照组(P<0.05),两组术中出血量、手术切口长度、治疗费用差异比较无统计学意义(P>0.05);VAS评分组间、时间点、组间×时间点比较,差异均具有统计学意义(P<0.05);两组术后1d、3d、7d VAS评分均依次降低(P<0.05),其中两组术后1d评分比较差异无统计学意义(P>0.05),术后3d、7d VAS评分显著低于对照组(P<0.05);观察组总并发症率为10.00%,对照组为18.97%,两组差异比较无统计学意义(P>0.05);术后随访6个月,观察组患者肘关节活动范围及Mayo评分均显著高于对照组(P<0.05)。结论:T形钢板联合Herbert螺钉内固定术治疗MasonⅢ型桡骨头骨折可显著提高临床疗效,缩短术后开始运动时间,降低术后疼痛反应,术后肘关节功能恢复良好,值得推荐。

Objective:To explore the efficacy of T-plate combined with Herbert screw internal fixation in the treatment of MasonⅢradial head fractures and its influence on perioperative indicators,elbow function score and complications.Methods:A total of 118 patients with MasonⅢradial head fractures in the hospital were randomly selected as the research subjects,and they were divided into observation group and control group according to the simple random method.The control group(n=58)was treated with T-plate fixation,and the observation group(n=60)was given T-plate combined with Herbert screw internal fixation.Perioperative indicators,pain score,postoperative complications and elbow function were compared between the two groups.Results:The clinical effective rate was 93.33%in observation group and 77.59%in control group,with a statistical difference(P<0.05).The surgical time and postoperative starting exercise time in observation group were significantly shorter or less than those in control group(P<0.05),and there were no statistical differences in intraoperative blood loss,surgical incision length,and treatment cost between the two groups(P>0.05).The differences were statistically significant(P<0.05)when comparing VAS scores between groups,time points and between groups x time points.The VAS scores of the two groups were decreased sequentially at 1d,3d,and 7d after surgery(P<0.05).There was no statistically significant difference in the score at 1d after surgery(P>0.05),and the VAS scores at 3d and 7d after surgery were significantly lower than those in control group(P<0.05).The total incidence rate of complications was 10.00%in observation group and 18.97%in control group(P>0.05)with no significant statistical difference.At 6 months in follow-up after surgery,the range of motion of elbow joint and Mayo score of observation group were significantly wider or higher than those of control group(P<0.05).Conclusion:T-plate combined with Herbert screw internal fixation in the treatment of MasonⅢradial head fractures can significantly improve the clinical efficacy and postoperative starting exercise time,reduce postoperative pain and restore good postoperative elbow function.