可吸收棒治疗MasonⅡ、Ⅲ型桡骨小头骨折临床疗效分析  

The clinical effect of absorbable rods in the treatment of Mason type Ⅱ, Ⅲ radial head fractures

作　　者：向成浩 陈文革[2] 蒋从斌[1] 彭聚胜[1] 陈刚[1] 杨万波[1] 余鹏[1] 

机构地区：[1]武警湖北省总队医院骨外一科(中国武警部队膝关节伤病中心),湖北武汉430060 [2]湖北民族学院附属民大医院关节外科,湖北恩施445000

出　　处：《生物骨科材料与临床研究》2015年第5期27-30,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨及总结MasonⅡ、Ⅲ型桡骨小头骨折手术切开复位可吸收棒内固定治疗的临床疗效。方法回顾性分析2010年3月~2014年2月我科治疗的59例桡骨小头骨折病人临床资料,其中男36例,女23例。年龄19~55岁。骨折类型采用Mason分型：Ⅱ型33例,Ⅲ型26例。均采用肘关节后外侧Kocher切口,术中根据桡骨小头骨折情况采用多枚可吸收棒内固定治疗,术后早期制动3~4周后逐渐加强患肢功能练习,并分别于术后第1、3、6、9、12个月定期门诊随访并摄X线片,按Metaizeau等的肘关节功能评分标准进行功能评估,并对相关手术并发症进行分析。结果所有患者切口愈合率100%,末次随访时按Metaizeau肘关节功能评分标准,总体优良率94.9%,其中33例MasonⅡ型桡骨小头骨折中,优32例,良0例,可0例,差1例,优良率97.0%;26例MasonⅢ型桡骨小头骨折中,优23例,良1例,可1例,差1例,优良率92.3%。术后共2例患者发生相关并发症（3.4%）,分别为桡骨小头缺血性坏死1例（1.7%）,内固定失效1例（1.7%）,均二期手术治疗。结论可吸收棒在治疗MasonⅡ、Ⅲ型桡骨小头骨折中具有明显的优势,其作为一种新型生物内固定材料,具有良好的生物相容性,其可在体内溶解吸收,且操作简便,勿需二次手术取出,可减少患者心理和生理负担以及术后相关并发症的发生,临床疗效满意,值得推广应用。Objective To explore and summarize the clinical effect of absorbable rods in the treatment of Mason typeⅡ,Ⅲ radial head fractures.Methods Retrospective analysis of 59 patients in our department from March 2010 to February2014, including 36 men and 23 women, ages 19 to 55 years old. According to the Mason classification, contains 33 cases of Ⅱ type fractures, 26 cases of Ⅲ type. On the basis of the situation of radial capitulum fractures using absorbable rods inline fixed treatment during the operation, early brake after 3 to 4 weeks, the patient gradually strengthen the limb function exercise and be taken X-ray after surgery in the clinic at 1, 3, 6, 9 and 12 months. Use Metaizeau evaluation criteria for function and analyze the related complications. Results The incision healing rate was 100% of all the patients, in accordance with Metaizeau elbow function score standards at the last follow-up, the excellent and good rate comes to 94.9%, 33 cases of Mason two-type fractures, the score was excellent of 32, good of 0, medium of 0 and poor of 1,and 26 cases of three-type fractures, the score was excellent of 23, good of 1, medium of 1 and poor of 1. Two of the patients occurred related complications（3.4%）, one of was Radial head necrosis（1.7%）, the other one was internal fixation failure（1.7%）. Conclusion Absorbable rods in the treatment of Mason Ⅱ, Ⅲ type of radial head fractures has obvious advantages, which takes as a new type of biological fixation materials, including good biocompatibility, absorbed in the body and easily operated. At same times, which can reduce the patients psychological or physiological burden and postoperative complications. It is satisfied of the clinical curative effect and is worthy of popularization and application.

关 键 词：桡骨小头骨折 可吸收棒 内固定 骨折 疗效 

分 类 号：R687.3[医药卫生—骨科学]