解剖型桡骨头假体置换治疗桡骨头粉碎性骨折  

Anatomic radial head prosthesis replacement for comminuted radial head fractures

作　　者：郭永智[1] 彭城[1] 李连华[1] 李绍光[1] 赵建文[1] 何红英[1] 戴鹤玲[1] 刘智[1] 

机构地区：[1]北京军区总医院创伤骨科研究所,100700

出　　处：《中国骨与关节杂志》2014年第3期184-188,共5页Chinese Journal of Bone and Joint

摘　　要：目的：探讨解剖型桡骨头假体置换治疗桡骨头粉碎性骨折的早期疗效。方法2009年6月至2013年5月，以Acumed解剖型桡骨头假体置换治疗桡骨头粉碎性骨折21例。男15例，女6例；年龄29～52岁，平均32.5岁。左侧8例，右侧13例。桡骨头骨折均为新鲜闭合粉碎性骨折，其中Mason III型8例， Mason IV型6例，肘部损伤“三联征”3例，Essex-Lopresti损伤2例，II型Monteggia骨折脱位2例。受伤至手术的时间平均为6.8（3～14）天。结果21例均获6～38个月，平均18.75个月的随访。未见切口感染、桡神经损伤、假体松动、肘关节不稳、创伤性关节炎等并发症，肘关节功能满意。其中2例遗留肘关节轻度疼痛；5例出现异位骨化，未对肘和前臂的运动造成明显影响。按照Broberg和Morrey肘关节功能评估标准进行功能评定：优10例，良8例，可2例，差1例，优良率为85.7%。结论 Acumed解剖型桡骨头假体置换治疗桡骨头粉碎性骨折有利于恢复肘关节的稳定、伸屈活动及前臂的旋转活动，可获得比较满意的疗效。Objective To explore the early clinical results of anatomic radial head prosthesis replacement in the treatment of comminuted radial head fractures. Methods From June 2009 to May 2013, a total of 21 patients underwent Acumed anatomic radial head prosthesis replacement for comminuted radial head fractures, including 15 men and 6 women, whose mean age was 32.5 years old （ range;29-52 years ）. There were 8 cases on the left side and 13 cases on the right side. All were fresh closed fractures. According to the Mason classiifcation, there were 8 cases of type III, 6 cases of type IV, 3 cases of terrible triad injury of the elbow, 2 cases of Essex-Lopresti injury and 2 cases of posterior olecranon fracture-dislocation of Monteggia type II. The operation was performed at 6.8 days after the injury on average （ range;3-14 days ）. Results All the patients were followed up for an average period of 18.75 months （ range;6-38 months ）. No incision infection, radial nerve injury, prosthetic loosening, elbow instability or traumatic osteoarthritis was found. There were 2 cases of mild pain in the elbow joint. Heterotopic ossiifcation was found in 5 cases, but no distinct limitation of locomotion of the elbow and forearm was noticed. According to the Broberg and Morrey rating system, the results showed 10 excellent cases, 8 good, 2 fair, and 1 poor. The excellent and good rate was 85.7%. Conclusions Acumed anatomic radial head prosthesis replacement is an effective method in the treatment of comminuted radial head fractures, which can better restore the stability, lfexion and extension of the elbow and the rotational motion of the forearm, with satisfactory clinical results.

关 键 词：桡骨骨折 骨折 粉碎性 关节成形术 置换 肘 肘关节 

分 类 号：R687.3[医药卫生—骨科学]