三种植入物内固定修复MasonⅡ-Ⅲ型桡骨头骨折的比较  

Comparative analysis of three different implants for the internal fixation of Mason Ⅱ-Ⅲ radial head fractures

作　　者：陆剑锋[1] 崔志浩 陆飞伟 刘宗宝[1] 王志荣 

机构地区：[1]苏州大学附属张家港市第一人民医院骨科,江苏省张家港市265600 [2]江苏省张家港市中医院骨科,江苏省张家港市215600

出　　处：《中国组织工程研究》2017年第27期4330-4335,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:可吸收材料是骨科近年来的研究热点之一,相对传统内固定,可吸收材料可以自行降解,避免内固定残留及二次取出手术创伤。目的:探讨可吸收棒及传统克氏针、螺钉置入内固定修复MasonⅡ-Ⅲ型桡骨头骨折的临床疗效及安全性。方法:收集2010年1月至2015年12月张家港市第一人民医院及张家港市中医院收治的桡骨头骨折患者45例,根据内固定植入物分为3组,分别置入克氏针、螺钉及可吸收棒,每组15例。比较3组术前一般资料、手术时间、失血量、愈合时间、术后肘关节功能Mayo评分和Broberg-Morrey评分。结果与结论:①3组术前一般资料、手术时间、失血量、骨折愈合时间比较差异均无显著性意义(P>0.05);②克氏针组、螺钉组、可吸收棒组Mayo评分分别为(88.45±6.22)、(92.37±5.60)、(90.82±6.58)分,Broberg-Morrey评分分别为(90.82±6.83)、(93.05±6.54)、(91.68±7.15)分,3组Mayo评分和Broberg-Morrey评分比较差异无显著性意义(P>0.05);③随访中克氏针组、螺钉组、可吸收棒组并发症发生率分别为20%(2/15)、13%(2/15)、7%(1/15),以克氏针组略高,但3组比较差异无显著性意义(P>0.05);④结果表明,可吸收棒置入修复MasonⅡ-Ⅲ型桡骨头骨折可获良好疗效,与传统内固定物基本等效,但避免了二次手术取出内固定的痛苦及应力性遮挡对骨折康复的不良影响,推荐临床应用。BACKGROUND： Absorbable material is a hotspot in orthopedics, which is biodegradable, avoids fixation residues and second surgical trauma compared with the traditional internal fixation.OBJECTIVE： To investigate the clinical efficacy and safety of K-wires, screws and absorbable rods for the internal fixation of Mason II-III radial head fractures.METHODS： Totally 45 patients with Mason Ⅱ-Ⅲ radial head fractures were collected from January 2010 to December 2015 admited in Zhangjiagang First People＇s Hospital and Zhangjiagang Hospital of Traditional Chinese Medicine, and were then divided into three groups （n=15 per group）, followed by implanted with K-wires （group A）, screws （group B）and absorbable rods （group C）, respectively. The baseline data, operation time, blood loss, healing time, Mayo and Broberg-Morrey scores were compared among groups.RESULTS AND CONCLUSION： （1） There were no significant differences in the baseline data, operation time, blood loss,and healing time among groups （P 〉 0.05）. （2） The Mayo scores in the groups A, B, and C were （88.45±6.22）,（92.37±5.60）, and （90.82±6.58）, respectively; the Broberg-Morrey scores in the groups A, B, and C group were （（90.82±6.83）, （93.05±6.54）, and （91.68±7.15）, respectively; all above scores showed no significant differences among groups （P 〉 0.05）. （4） The total incidence rate of complications in the groups A, B, and C was 20％ （2/15）, 13％ （2/15）,and 7％ （1/15） respectively, showing no significant difference among groups （P 〉 0.05）. （4） These results indicate that the absorbable rods can obtain satisfactory treatment outcomes for Mason II-III radial head fractures, which is equivalent to the traditional internal fixation. Moreover, it can avoid secondary operation for removing internal fixators and the adverse impact of stress shielding, so it is recommended to be used in clinic.

关 键 词：骨科植入物 骨植入物 桡骨头骨折 Mason分型 可吸收棒 Mayo评分 Broberg-Morrey评分 

分 类 号：R318[医药卫生—生物医学工程]