无头加压中空埋入螺钉内固定治疗肘关节内骨折的疗效  

Effectiveness of internal fixation with headless compression hollow embedding screws for intraarticular fracture of elbow

作　　者：段亮[1] 弓立群[1] 范亚一[1] 祁洁[1] 李伟伟[1] 卫文博[1] 赵伟 DUAN Liang;GONG Liqun;FAN Yayi;QI Jie;LI Weiwei;WEI Wenbo;ZHAO Wei(Department of Orthopedics,Shaanxi People's Hospital,Xi'an Shaanxi,710068,P.R.China)

机构地区：[1]陕西省人民医院骨科

出　　处：《中国修复重建外科杂志》2019年第8期986-990,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：陕西省自然科学基金资助项目(2014JQ4125)~~

摘　　要：目的探讨无头加压中空埋入螺钉内固定治疗肘关节内骨折的疗效。方法 2012年3月-2018年9月,采用无头加压中空埋入螺钉内固定治疗12例肘关节内骨折。男7例,女5例;年龄22~65岁,平均50.3岁。致伤原因:摔伤7例,高处坠落伤4例,交通事故伤1例。肱骨远端骨折10例,按照国际内固定研究协会(AO/ASIF)分型13-B3型8例、13-C3型2例;桡骨头骨折2例,按照改良Mason分型均为Ⅲ型。术前疼痛视觉模拟评分(VAS)为(8.25±0.83)分。受伤至手术时间为3~5 d,平均3.7 d。结果术后切口均Ⅰ期愈合。12例均获随访,随访时间6~15个月,平均8.4个月。X线片及CT复查显示,骨折端解剖复位,术后6~11个月骨折均达骨性愈合,平均7.8个月;1例术后4个月出现异位骨化。术后2周VAS评分为(5.17±0.79)分,末次随访时为(0.50±0.50)分,手术前后各时间点间比较差异均有统计学意义(P<0.05)。末次随访时,Mayo肘关节功能评分为68~95分,平均83.9分。肘关节活动度恢复良好。结论采用无头加压中空埋入螺钉内固定肘关节内骨折牢固,允许术后早期肘关节功能训练,异位骨化发生率低,可获得较好疗效。Objective To evaluate the effectiveness of internal fixation with headless compression hollow embedding screws in the treatment of intraarticular fracture of elbow. Methods Between March 2012 and September 2018, 12 patients with intraarticular fracture of elbow were treated with internal fixation with headless compression hollow embedding screws. There were 7 males and 5 females with an average age of 50.3 years(range, 22-65 years). Cause of injury included falling in 7 cases, falling from high places in 4 cases, and traffic accident in 1 case. Ten patients were distal humerus fractures which were classified as type 13-B3 in 8 cases and type 13-C3 in 2 cases according to the International Association of Internal Fixation Research(AO/ASIF). Two patients were radial head fractures which were classified as type Ⅲ according to the modified Mason classifications. The preoperative visual analogue scale(VAS) score was 8.25±0.83. The time from injury to operation was 3-5 days(mean, 3.7 days). Results All incisions healed by first intention. All 12 patients were followed up 6-15 months, with an average of 8.4 months. The results of X-ray films and CT examination showed that the fracture ends were anatomic reduction, and the fractures healed at 6-11 months after operation, with an average of 7.8 months. One patient had heterotopic ossification at 4 months after operation. The VAS scores were 5.17±0.79 at 2 weeks after operation and 0.50±0.50 at last follow-up. There were significant differences between the time points(P<0.05). At last follow-up, the Mayo elbow function score was 68-95, with an average of 83.9.The activity of elbow joint recovered. Conclusion The intraarticular fracture of elbow can be firmly fixed by the headless compression hollow embedding screw, which can allow the early functional training of the elbow joint, reduce the incidence of heterotopic ossification, and obtain good effectiveness.

关 键 词：无头加压中空埋入螺钉 肘关节 关节内骨折 内固定 

分 类 号：R687.3[医药卫生—骨科学]