空心加压埋头螺钉内固定治疗MasonⅡ、Ⅲ型桡骨头骨折

Internal fixation with cannulated compression countersunk head screws for the treatment of Mason typeⅡandⅢradial head fractures

目的探讨空心加压埋头螺钉内固定治疗MasonⅡ、Ⅲ型桡骨头骨折的疗效。方法采用空心加压埋头螺钉内固定治疗46例MasonⅡ、Ⅲ型桡骨头骨折患者。记录骨折复位情况、骨折愈合时间、术后并发症发生情况、肘关节活动度。采用Broberg-Morrey评分标准评价肘关节功能。结果患者均获得随访,时间12~36个月。骨折解剖复位35例,功能复位11例。骨折均愈合,时间12~24周。术后无骨折移位、桡神经深支损伤、特异性炎症、关节不稳、疼痛和骨折畸形愈合等并发症发生。末次随访时,肘关节屈曲120°~140°、过伸5°~10°;前臂旋前80°~90°、旋后80°~90°;采用Broberg-Morrey评分标准评价肘关节功能:优29例,良13例,可4例,优良率为91.3%。结论空心加压埋头螺钉内固定治疗MasonⅡ、Ⅲ型桡骨头骨折,具有创伤小、安全性高、骨折固定稳固、患者可早期恢复肘关节功能、并发症少、无需取出内固定的优点。

Objective To investigate the effect of internal fixation with cannulated compression countersunk head screw for the treatment of Mason typeⅡandⅢradial head fractures.Methods The 46 cases of Mason typeⅡandⅢradial head fractures were treated by internal fixation with cannulated compression countersunk head screws.The fracture reduction conditions,fracture healing time,incidence of postoperative complications and elbow joint range of motion were recorded.The Broberg-Morrey scoring criterion was used to evaluate elbow joint function.Results All patients were followed up for 12~36 months.There were 35 cases of anatomical reduction of fractures and 11 cases of functional reduction.All fractures healed within 12~24 weeks.There were no postoperative complications such as fracture displacement,deep branch injury of the radial nerve,specific inflammation,joint instability,pain,and malunion of fractures.At the last follow-up,the range of motion of the elbow joint was flexion with 120°~140°,hyperextension with 5°~10°;forearm pronation was 80°~90°,forearm supination was 80°~90°.Using the Broberg-Morrey scoring system to evaluate elbow joint function,29 cases were excellent,13 good,and 4 fair,with an excellent-good rate of 91.3%.Conclusions Cannulated compression countersunk head screw internal fixation for the treatment of Mason typeⅡandⅢradial head fractures has the advantages of less trauma,high safety,stable fracture fixation,early recovery of elbow joint function,fewer complications,and no need for internal fixation removal.