不同内固定物手术治疗MasonⅡ、Ⅲ型桡骨头骨折的效果

Effect of Different Internal Fixation in the Treatment of Mason TypeⅡandⅢRadial Head Fractures

目的:探讨不同内固定物手术治疗MasonⅡ、Ⅲ型桡骨头骨折的效果。方法:回顾性分析北京市朝阳区双桥医院骨科2013年1月-2020年12月接受治疗的96例MasonⅡ、Ⅲ型桡骨头骨折患者。根据手术内固定材料不同,将其分为微型钢板组(32例)和埋头空心螺钉组(31例)及克氏针组(33例)。比较三组术前及术后1、4、8、12周疼痛程度,并发症,术前、术后1、4、12周及12个月肘关节功能,优良率。结果:术后1、4、8、12周,三组疼痛数字评价量表(numerical rating scale,NRS)评分较术前均有明显下降(P<0.05),但三组NRS评分比较差异无统计学意义(P>0.05)。克氏针组并发症发生率高于微型钢板组和埋头空心螺钉组(P<0.05)。术后1、4、12周、12个月,三组Broberg-Morrey评分均较术前明显升高(P<0.05),三组Broberg-Morrey评分比较差异无统计学意义(P>0.05)。末次随访三组优良率比较差异无统计学意义(P>0.05)。结论:对于MasonⅡ型、Ⅲ型桡骨头骨折,微型钢板、埋头空心螺钉治疗可以取得良好的临床效果,可以作为桡骨头骨折的治疗选择。

Objective:To investigate the effect of different internal fixation in the treatment of Mason typeⅡandⅢradial head fractures.Method:A retrospective analysis was performed on 96 patients with Mason typeⅡandⅢradial head fractures who received treatment from January 2013 to December 2020 in Shuangqiao Hospital of Chaoyang District of Beijing.According to the different internal fixation materials,they were divided into micro plate group(32 cases),countersunk hollow screw group(31 cases)and Kirschner wire group(33 cases).The pain degree before and 1,4,8,12 weeks after surgery,complications,elbow joint function before and 1,4,12 weeks,12 months after surgery and excellent and good rate of the three groups were compared.Result:At 1,4,8 and 12 weeks after surgery,the scores of numerical rating scale(NRS)in the three groups were significantly lower than those before surgery(P<0.05),but there was no significant difference in NRS scores among the three groups(P>0.05).The incidence of complications in the Kirschner wire group was higher than that the micro plate group and countersunk hollow screw group(P<0.05).At 1,4,12 weeks and 12 months after surgery,the Broberg-Morrey scores in the three groups were significantly higher than those before surgery(P<0.05),and there was no significant difference in the Broberg-Morrey scores among the three groups(P>0.05).There was no significant difference in the excellent and good rate among the three groups at the last follow-up(P>0.05).Conclusion:For Mason typeⅡand typeⅢradial head fractures,micro plate and countersunk hollow screw treatment can achieve good clinical effect and can be used as the treatment option for radial head fractures.