弹性钉闭合复位内固定微创治疗成人Mason Ⅱ型桡骨头骨折  

Closed reduction and internal fixation with elastic nail for Mason type Ⅱ radial head fracture in adults

作　　者：高旭 尹海磊[3] 卢建峰 GAO Xu;YIN Hailei;LU Jianfeng(Qingdao University,Qingdao Shandong,266071,P.R.China;Department of Orthopedics,the Affiliated Hospital of Qingdao University,Qingdao Shandong,266071,P.R.China;The Second Department of Orthopedics,No.401 Hospital of the Chinese PLA,Qingdao Shandong,266071,P.R.China)

机构地区：[1]青岛大学,山东青岛266071 [2]青岛大学附属医院骨科,山东青岛266071 [3]中国人民解放军第401医院骨二科,山东青岛266071

出　　处：《中国修复重建外科杂志》2019年第8期981-985,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨弹性钉闭合复位内固定治疗成人MasonⅡ型桡骨头骨折的临床疗效。方法回顾分析2013年5月-2017年3月收治的28例成人MasonⅡ型桡骨头骨折患者临床资料,其中13例行弹性钉闭合复位内固定治疗(试验组),15例行Herbert螺钉切开复位内固定治疗(对照组)。两组患者性别、年龄、致伤原因、骨折侧别及受伤至手术时间比较,差异均无统计学意义(P>0.05),具有可比性。记录并比较两组手术时间、术中出血量、术中透视次数。术后X线片复查骨折愈合情况以及有无桡骨头坏死、异位骨化等并发症发生。末次随访时,根据Mayo肘关节功能评分评估疗效。结果两组患者均获随访,随访时间12~30个月,平均21.9个月。试验组手术时间、术中出血量明显少于对照组,而术中透视次数增加,差异均有统计学意义(P<0.05)。X线片复查示,两组骨折均愈合;试验组骨折愈合时间为(2.85±0.69)个月,对照组为(3.35±0.88)个月,差异无统计学意义(t=1.654,P=0.110)。对照组2例发生异位骨化。末次随访时,根据Mayo肘关节功能评分标准,试验组为(90.6±5.3)分,对照组为(86.4±7.1)分,两组评分差异无统计学意义(t=1.750,P=0.092)。结论对于MasonⅡ型桡骨头骨折,弹性钉闭合复位内固定作为一种微创方法,具有手术时间短、出血量少等优势。Objective To investigate the effectiveness of closed reduction and internal fixation with elastic nails in treatment of Mason type Ⅱ radial head fracture in adults. Methods A clinical data of 28 patients with Mason type Ⅱradial head fractures between May 2013 and March 2017 was retrospectively analyzed. Thirteen patients were treated with closed reduction and internal fixation with elastic nails(trial group);15 patients were treated with open reduction and internal fixation with Herbert screws(control group). There was no significant difference in gender, age, cause of injury,side of fracture, and the time from injury to operation between the two groups(P>0.05). The operation time, blood loss,and fluoroscopy times in the two groups were recorded and compared. Postoperative X-ray films were used to evaluate the bone healing, heterotopic ossification, and necrosis of radial head. The effectiveness was evaluated according to Mayo score criteria of the elbow at last follow-up. Results All patients were followed up 12-30 months(mean, 21.9 months).The operation time and blood loss were significantly less in the trial group than in the control group(P<0.05), while the fluoroscopy times significantly increased in the trial group than in the control group(P<0.05). X-ray films showed that all fractures healed with the bone healing time of(2.85±0.69) months in the trial group and(3.35±0.88) months in the control group. There was no significant difference in bone healing time between the two groups(t=1.654, P=0.110). Heterotopic ossification occurred in 2 cases in the control group. At last follow-up, there was no significant difference in the Mayo scores between the trial group(90.6±5.3) and the control group(86.4±7.1)(t=1.750, P=0.092). Conclusion Closed reduction and internal fixation with elastic nails, as a minimally invasive technique, has advantages of short operation time and less bleeding in the treatment of Mason type Ⅱ radial head fracture.

关 键 词：桡骨头骨折 MASON Ⅱ型 弹性钉 闭合复位 内固定 成人 

分 类 号：R687.3[医药卫生—骨科学]