桡骨头切除术与人工假体置换术治疗MasonⅢ型桡骨头骨折的效果比较  

Efficacy of radial head resection and artificial prosthesis replacement on MasonⅢradial head fractures

作　　者：袁伟 王明鹤 代耀军 薛发龙 燕冰 Yuan Wei;Wang Minghe;Dai Yaojun;Xue Falong;Yan Bing(Department of Orthopaedics,Zhengzhou Orthopaedics Hospital,Zhengzhou 450000,China;Zhengzhou Health Vocational College,Zhengzhou 450000,China;Department of Orthopaedics,Tongxu Hospital of Traditional Chinese Medicine,Tongxu 475400,China)

机构地区：[1]郑州骨科医院骨科,450000 [2]郑州卫生健康职业学院,450000 [3]河南省通许县中医院骨科,475400

出　　处：《中国实用医刊》2021年第3期46-49,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较桡骨头切除术与人工假体置换术治疗MasonⅢ型桡骨头骨折的效果。方法回顾性分析2016年1月至2019年3月郑州骨科医院收治的60例MasonⅢ型桡骨头骨折患者的病例资料,其中34例实施人工假体置换术者纳入置换组,26例实施桡骨头切除术者纳入切除组。比较两组患者手术相关指标(手术时间、术中失血量),视觉模拟评分法(VAS)评分,肘关节功能(Broberg和Morrey评分),肘关节屈曲、旋转度、提携角及并发症发生情况。结果置换组手术时间为(52.35±2.07)min,少于切除组的(61.58±2.21)min,P<0.05;两组术中出血量比较差异未见统计学意义(P>0.05)。两组患者术前及术后3、6个月VAS评分比较差异未见统计学意义(P>0.05);置换组患者术后14 d VAS评分为(4.07±1.05)分,低于切除组的(5.45±0.93)分(P<0.05)。术后14 d、3个月、6个月、12个月,置换组Broberg和Morrey评分均高于切除组(P均<0.05);术后12个月,置换组肘关节屈曲度、肘关节旋前度、肘关节旋后度均大于切除组,肘关节提携角较健侧增加值小于切除组(P<0.05)。置换组并发症发生率(5.88%,2/34)低于切除组(38.46%,10/26),P<0.05。结论与桡骨头切除术相比,人工假体置换术治疗MasonⅢ型桡骨头骨折术后疼痛感更轻微,术后肘关节活动功能恢复更佳,且并发症更少。Objective To compare the efficacy of radial head resection and artificial prosthesis replacement in the treatment of MasonⅢradial head fractures.Methods The clinical data of 60 patients with MasonⅢradial head fractures treated in Zhengzhou Orthopaedics Hospital from January 2016 to March 2019 were retrospectively analyzed.Among them,34 patients who underwent prosthesis replacement were included in the replacement group,and 26 patients who underwent radial head resection were included in the resection group.The surgery-related indicators(surgical time,intraoperative blood loss),visual analogue scale(VAS)score,elbow joint function(Broberg score and Morrey score),elbow joint flexion,elbow joint rotation,elbow joint carrying angle,and occurrence of complications were compared between the two groups.Results The surgical time in replacement group was(52.35±2.07)min,shorter than the(61.58±2.21)min in resection group(P<0.05).There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).There was no significant difference in VAS score before surgery,and 3 months and 6 months after surgery between the two groups(P>0.05).The 14-day postoperative VAS score in replacement group was 4.07±1.05,lower than the 5.45±0.93 in resection group(P<0.05).The Broberg score and Morrey score in replacement group were higher than those in resection group 3 months,6 months and 12 months after surgery(P<0.05).The elbow joint flexion,elbow joint pronation,and elbow joint supination in replacement group were greater than those in resection group,and the increase in elbow joint carrying angle was smaller than that in resection group 12 months after surgery(P<0.05).The incidence of complications in replacement group(5.88%,2/34)was lower than that in resection group(38.46%,10/26),P<0.05.Conclusions Compared with radial head resection,artificial prosthesis replacement in the treatment of MasonⅢradial head fractures has milder postoperative pain,better recovery of elbow joint mobility,and fewe

关 键 词：桡骨头骨折 MasonⅢ型 桡骨头切除术 人工假体置换术 

分 类 号：R687.3[医药卫生—骨科学]