手术治疗桡骨头骨折的疗效分析  

Therapeutic Effect of Surgical Treatment on Radial Head Fractures

作　　者：丁磊[1] 张新潮[1] 徐吉[1] 刘志勇[1] 

机构地区：[1]复旦大学附属金山医院骨科,上海201508

出　　处：《中国临床医学》2014年第1期41-42,共2页Chinese Journal of Clinical Medicine

摘　　要：目的：探讨不同类型桡骨头骨折的手术治疗方法及其疗效。方法：回顾分析2006年1月-2011年12月手术治疗的36例桡骨头骨折患者的临床资料，其中MasonⅡ型22例，Ⅲ型9例，IV型5例。根据骨折类型选用合适的手术治疗方法。结果：36例患者均获得随访，随访时间12～36个月，平均20．8个月，术后骨折均愈合，1例Ⅲ型骨折患者发生骨化性肌炎，无感染或神经损伤发生。按Broberg和Morrey的评估标准进行功能评定，优28例，良4例，可3例，差1例，优良率为88．9％。Ⅱ型骨折患者术后患侧关节活动度与健侧比较差异无统计学意义，而Ⅲ型、Ⅳ型骨折患者术后患侧关节活动度与健侧比较差异有统计学意义。结论：MasonⅡ型骨折采用骨折切开复位内固定可以取得满意效果；Ⅲ、Ⅳ型骨折首选骨折切开复位内固定，若手术失败可行桡骨头置换。Objective： To investigate the operative methods and therapeutic effect of surgical treatment of different types of radial head fractures. Methods：A total of 36 patients with radial head fractures, treated with open reduction and internal fixa- tion from Jan 2006 to Dec 2011, were enrolled in this study. According to the Mason classification, there were 22 patients with Mason type Ⅱ , 9 patients with Mason type Ⅲ and 5 patients with Mason type Ⅳ fractures. Operative treatments were based on the types of fractures. Results： All the patients have been followed up for an average of 20.8 months （ranged from 12 to 36 months）. All the fractures were healed, but 1 case suffered from heterotopic ossification. No infection or nerve injury was found. According to the Broberg and Morrey score systems, elbow function was excellent in 26 patients and good in 3 patients, and the excellent and good rate was 88.9%. No significant difference was found in the movement range between the hurt and normal joint in patients with Mason type Ⅱ fracture, while there were significant differences in the movement range in patients with Mason type Ⅲ and Mason Ⅳ fractures. Conclusions： Satisfactory results are got by open reduction and internal fixation in Mason type Ⅱ fracture, and it should be taken as the first choice in Mason type Ⅲ and Ⅳ fractures. Arthroplasty should be performed after internal fixation failure.

关 键 词：桡骨头骨折 关节置换 手术治疗 

分 类 号：R683.41[医药卫生—骨科学]