桡骨小头置换治疗Mason Ⅲ型桡骨小头骨折的临床疗效观察  

The preliminary clinical efficacy of treatment for Mason type-Ⅲ radial head fractures with radial head arthroplasty

作　　者：赵加松[1] 扶世杰[1] 汪国友[1] 沈骅睿[1] 曾胜强[1] 郝琦[1] 

机构地区：[1]泸州医学院附属中医医院骨关节科,646000

出　　处：《中华肩肘外科电子杂志》2014年第4期235-239,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：四川省科技厅基金(2010HH0054)

摘　　要：目的：探讨采用桡骨小头置换治疗 Mason Ⅲ型桡骨小头骨折早期临床疗效。方法对2010年3月至2013年3月我院收治的9例 Mason Ⅲ型桡骨小头骨折患者予以桡骨小头置换，采用Broberg和 Morrey的肘关节功能评分标准，评价术后早期疗效。结果患者全部得到随访，术后随访6~36个月，平均19.6个月，优5例、良3例、中1例，本组病例随访时均未发现肘关节感染、强直或脱位，慢性肘关节炎及肘、前臂和腕部长期慢性疼痛等并发症。结论桡骨小头置换治疗 MasonⅢ型桡骨小头骨折早期临床疗效良好，远期疗效有待进一步评价。Background Comminuted radial head fractures were difficult to treat with open reduction and internal fixation.Radial head arthroplasty was a favourable technique for the treatment of complex radial head fractures.The purpose of this study was to evaluate the early clinical efficacy of radial head arthroplasty for the treatment of Mason type-Ⅲ radial head fractures.Methods We retrospectively reviewed 9patients who suffered from Mason type-Ⅲ radial head fractures requiring radial head arthroplasty between March 2010 and March 2013.In these nine patients,There were 6female and 3 male with mean age 29.4(24-36years),7patients combined with medial collateral ligament injury and interosseous membrane damage,two patients combined fractures of the proximal ulna.According to Mason classification,Fractures of the radial head had been classified as follow,typeⅠ:radial head or neck fracture,with no or minimal displacement;TypeⅡ:radial head or neck fracture,fracture displacement >2 mm;Type Ⅲ:Severe comminuted radial head and radial neck fractures;Type IV:If the patients associated with dislocation of the elbow and forearm interosseous membrane damage,the typeⅢ fractures may be referred to Mason Johnston type IV.All of the nine patients were Mason Johnston typeⅢ.Surgical technique as follows:After the success of the brachial plexus or general anesthesia,a tourniquet was tied up to the ipsilateral arm,then the routine disinfection and draping were performed. We used the Kocher approach to open the skin and subcutaneous tissue,the incision was about 6 ~ 8cm,Then,through the interval between the anconeus and the extensor carpiulnaris(ECU)to expose the lateral capsule of the elbow.During the operation,the forearm pronation should be kept to protect the posterior interosseous nerve.Identified the head fracture,and we removed all fragments of the unreconstructable head.A cutting guide was used in order to achieve a good resection,which must be perpendicular to the axis of the radius.The parts of the broken head were rea

关 键 词：桡骨小头 骨折 粉碎性 置换 治疗 临床研究性 

分 类 号：R687.3[医药卫生—骨科学]