指掌骨接骨板治疗不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折的临床体会

BClinical outcome of metacarpal plate in the treatment of Mason typeⅡ/Ⅲradial head fractures without involving the radial neck

目的 探索切开复位指掌骨接骨板内固定术治疗不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折的临床疗效。方法 回顾性收集中部战区总医院骨科2019年9月至2021年5月收治的44例不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折患者为研究对象,实施切开复位指掌骨接骨板内固定手术,所纳入患者行Mayo肘关节评分、上肢功能评定表(DASH)评分、视觉模拟评分(VAS),测量手术切口长度,记录术后并发症。结果 随访12~32个月(平均18.5个月),在末次随访时,所有桡骨头均骨性愈合。Mayo肘关节评分平均为(88.9±0.6)分,优良率97.7%(43/44);上肢功能评定表(DASH)评分平均(7.3±0.7)分;视觉模拟评分(VAS)平均(1.6±0.1)分;三种评分较术前均有显著改善。术后切口长度为(5.6±0.1)cm。术后1例患者出现肘关节僵硬,其余未见明显术后并发症。结论 通过指掌骨接骨板内固定治疗不累及桡骨颈的Mason Ⅱ、Ⅲ型桡骨头骨折,术后患者肘关节功能恢复良好,切口小,术后并发症少,临床上推荐应用。

Objective To explore the clinical outcome of open reduction and metacarpal plate internal fixation in the treatment of Mason typeⅡ/Ⅲradial head fractures without involving the radial neck.Methods Forty-four cases of Mason typeⅡ/Ⅲradial head fractures without involving the radial neck were retrospectively collected from the General Hospital of Central Theater Command from September 2019 to May 2021.Open reduction and metacarpal plate internal fixation were performed.The Mayo Elbow score,the score of the disorders of the arm,shoulder and hand(DASH),and the visual analog scale(VAS)were evaluated at the last follow-up.The length of incision was measured,and the postoperative complications were recorded.Results All the patients were followed up for 12-32 months(mean 18.5 months).At the last follow-up,the Mayo Elbow score was 88.9±0.6;the excellent and good rate was 97.7%(43/44);the DASH was 7.3±0.7;the VAS was 1.6±0.1.The length of incision was(5.6±0.1)cm.One patient developed elbow stiffness after operation,and the others had no obvious postoperative complications.Conclusion Masson typeⅡ/Ⅲradial head fractures without involving the radial neck can be treated by internal fixation with metacarpal plate.The elbow function of the patients recovered well after operation,and the postoperative complications are less.This technique is recommended in clinical practice.