三种方法治疗成人MasonⅢ型桡骨头骨折的临床疗效分析  

Clinical analysis of three methods for treatment of Mason type Ⅲ radial head fracture in adults

作　　者：梅毅宁 杨秋贤 Mei Yining;Yang Qiuxian

机构地区：[1]台山市中医院,广东江门529200

出　　处：《中医临床研究》2020年第33期114-116,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨手术治疗与保守治疗MasonⅢ型桡骨头骨折的临床疗效,探讨保守治疗的应用价值。方法:选取台山市中医院2017年1月-2019年1月收治的桡骨头骨折患者30例。患者资料:年龄21~47岁,男性17例,女性13例,致伤原因:摔伤13例,交通伤8例,高处坠落伤9例,分成三组,第一组10例,采用手法整复外固定及中医药物外用治疗(夹板期使用自制跌打油,去除外固定后,使用自拟通络舒筋汤熏洗),第二组10例,采用切开复位内固定术治疗,第三组10例采用桡骨头切除术治疗。对住院天数、住院费用、术后12个月Morrey肘关节评分患肢功能优良率、术后12个月肘关节活动度、术后12个月患肘肌力减少情况、患者满意度等进行比较。结果:第一组患者住院天数及住院费用明显小于后两组,差异具有统计学意义(P<0.05),第三组治疗后患肢后伸肘、屈肘、旋前、旋后及握力等功能及临床疗效明显低于前两组,差异具有统计学意义(P<0.05),第三组与第一、二组比较,满意率明显下降,差异具有统计学意义(P<0.05)。所有患者均获随访,时间为12个月。结论:对成人MasonⅢ型桡骨头骨折,多采用手术治疗,基层医院由于技术及患者资金等原因,一般很少采用人工桡骨头置换术,多采用切开复位内固定术或桡骨头切除术,而桡骨头切除术作为传统性手术,多年的开展也显示出其存在很多的不足。台山市中医院采用保守治疗桡骨头粉碎性骨折,与上两组治疗方法计较,也取得相对满意的疗效。Objective:To explore the clinical effect of surgical treatment and conservative treatment of Mason Type III radial head fracture,and to explore the value of conservative treatment.Methods:From January 2017 to January 2019,30 patients with radial head fracture were selected.The patients were aged from 21 to 47 years old,including 17 males and 13 females,with the causes of injury:13 cases of falling injury,8 cases of traffic injury and 9 cases of falling injury.They were divided into three groups.The patients in the first group(10 cases)received manual reconstructive external fixation treatment and external application of traditional Chinese medicine,the patients in the second group(10 cases)were treated by open reduction and internal fixation,while the patients in the thrid group(10 cases)were treated by radial head resection.The length of hospital stay,hospital expenses,Morrey elbow joint score at 12 months,elbow joint mobility at 12 months,muscle strength reduction at 12 months,and patient satisfaction were compared.Results:The hospitalization days and expenses of the first group were significantly less than those of the latter two groups(P<0.05),after treatment,the function and clinical effect of the patients in the third group were significantly lower than those in the first two groups(P<0.05).The satisfaction rate of the patients in the third group was significantly lower than that in the first two groups,the difference was statistically significant(P<0.05).All patients were followed up for 12 months.Conclusion:For Mason Type III radial head fractures in adults,surgical treatment is usually used.In primary hospitals,artificial radial head replacement is rarely used,and open reduction and internal fixation or radial head resection are often used,as a traditional operation,radial head resection has been performed for many years,but there are many shortcomings.The conservative treatment of radial head bone fracture in Taishan Hospital of Traditional Chinese Medicine has achieved relatively satisfactory results c

关 键 词：MasonⅢ型桡骨头骨折 桡骨头切除术 内固定术 外固定 

分 类 号：R683.[医药卫生—骨科学]