冠突骨折时桡骨小头切除对肘关节稳定性的影响  

Biomechanical influence of elbow joint stability on radial head comminuted fractures merging coronoid process fractures after experimental excision of radial head

作　　者：宋景仑 王鹏程 张奉琪 

机构地区：[1]河北省邢台矿业集团总医院骨二科,054000

出　　处：《中国医师进修杂志（外科版）》2007年第6期27-29,共3页Chinese Journal of Postgraduates of Medicine

基　　金：河北省科技厅攻关项目（052761665）

摘　　要：目的分析桡骨小头粉碎性骨折合并各种类型的尺骨冠突骨折行桡骨小头切除前后肘关节的稳定性。方法选取上肢尸体标本20具，测试桡骨小头粉碎性骨折合并各种冠突骨折行桡骨小头切除前后肘外翻位移及外旋转角。结果桡骨小头粉碎性骨折合并冠突无骨折、Ⅰ型骨折、Ⅱ型骨折，行桡骨小头切除前后肘外翻位移及外旋转角差异无统计学意义（P〉0．05），冠突Ⅲ型骨折行桡骨小头切除前后肘外翻位移及外旋转角差异有统计学意义（P〈0．05）。结论桡骨小头粉碎性骨折合并冠突Ⅰ型、Ⅱ型骨折行桡骨小头切除前后肘关节均稳定，可行桡骨小头切除术，Ⅲ型骨折不稳定，应修复桡骨小头或行假体置换，并修复冠突及尺桡侧副韧带。Objective To determine the elbow joint stability on the radial head eomminuted fracture merging each type of the eoronoid process fractures after experimental excision of the radial head. Method Twenty pairs of embalmed anatomic specimen epipods were selected, testing the elbow joint eversion displacement and the external rotation comer before and after experimental excision of the radial head. Results The elbow eversion displacement and extemalrotation comer were not statistically significant difference among the eoronoid process without fracture, the type Ⅰ fracture and the type Ⅱ fracture before and after experimental excision of the radial head（P 〉0.05 ） , but the elbow eversion displacement of the type Ⅲ fracture were significantly increased （P 〈 0.05）. Conclusions For the type Ⅰ and Ⅱ fracture under the condition of the radial head eomminuted fracture merging eoronoid process, the elbow are stable before and after experimental excision of the radial head For the type Ⅲ fracture, it is unsteady, it should be operated to repair the radial head fracture or do the prosthetic replaeemeut while repairing the eoronoid process, medial collateral ligament and lateral collateral ligament.

关 键 词：桡骨小头 肘关节 骨折 生物力学 

分 类 号：R684.7[医药卫生—骨科学]