弹性髓内钉内固定治疗成人MasonⅡ型桡骨头骨折  

Internal fixation with elastic intramedullary nail for treatment of adult MasonⅡradial head fractures

作　　者：戴世友[1] 赵蕾[2] 祝绍隆 唐长华 尹海磊 DAI Shi-you;ZHAO-Lei;ZHU Shao-long;TANG Chang-hua;YIN Hai-lei(Department of Bone and Joint and Sports Medicine,East District of Qingdao Municipal Hospital,Qingdao,Shandong 266000,China;不详)

机构地区：[1]青岛市市立医院东院区骨关节与运动医学科,山东青岛266000 [2]青岛市市立医院东院区感染管理科,山东青岛266000 [3]海军第971医院健康管理中心,山东青岛266001 [4]海军第971医院康复医学与理疗科,山东青岛266001 [5]海军第971医院骨科二病区,山东青岛266001

出　　处：《中国骨与关节损伤杂志》2022年第9期917-920,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较弹性髓内钉内固定与切开复位钢板内固定治疗成人MasonⅡ型桡骨头骨折的临床疗效。方法回顾性分析自2016-04—2019-04诊治的46例成人MasonⅡ型桡骨头骨折,24例采用弹性髓内钉内固定治疗(观察组),22例采用切开复位钢板内固定治疗(对照组)。比较两组手术时间、术中出血量、住院时间、术中透视次数、骨折愈合时间,比较两组末次随访时的肘关节屈伸活动度、前臂旋前活动度、前臂旋后活动度以及术后1、3、6个月的肘关节功能Brobery-Morrey评分。结果两组均顺利完成手术,随访时间10~18个月,平均14.8个月。对照组出现1例异位骨化,肘关节屈伸活动轻度受限,经系统康复锻炼后恢复正常。观察组手术时间、术中出血量、住院时间较对照组少,术中透视次数较对照组多,差异有统计学意义(P<0.05)。两组骨折愈合时间比较差异无统计学意义(P>0.05)。末次随访时观察组肘关节屈伸活动度较对照组大,差异有统计学意义(P<0.05);两组前臂旋前活动度、前臂旋后活动度比较差异无统计学意义(P>0.05)。术后1个月、3个月观察组肘关节功能Brobery-Morrey评分较对照组高,差异有统计学意义(P<0.05);术后6个月两组肘关节功能Brobery-Morrey评分比较差异无统计学意义(P>0.05)。结论弹性髓内钉内固定治疗成人MasonⅡ型桡骨头骨折可达到良好的手术效果,且具有操作简单、手术创伤小、手术时间短、术中出血量少等优点,有利于早期康复治疗,在把握手术适应证的基础上,值得临床推广应用。ObjectiveTo compare the clinical efficacy of internal fixation with elastic intramedullary nailing and open reduction and internal fixation with plate in the treatment of Mason typeⅡradial head fractures in adults.MethodsForty-six cases of adult Mason typeⅡradial head fractures treated from April 2016 to April 2019 were retrospectively analyzed.Among them,24 cases were treated with internal fixation by elastic intramedullary nailing(observation group)and 22 cases were treated with internal fixation by incisional repositioning plate(control group).The operative time,intraoperative bleeding,hospital stay,number of intraoperative fluoroscopies,and fracture healing time were compared between the two groups.The elbow flexion and extension mobility,forearm pronation mobility,forearm supination mobility,and the Brobery-Morrey score of elbow function at1,3,and 6 months postoperatively were compared between the two groups at the last follow-up.ResultsThe surgical treatment was completed successfully in both group and they were followed-up time of 10 to 18 months,with a mean of 14.8 months.In the control group,there was one case of heterotopic ossification and mild limitation of elbow flexion and extension activities,which returned to normal after systematic rehabilitation exercises.The observation group had less operative time,intraoperative bleeding,and hospital stay than the control group,and more intraoperative fluoroscopy than the control group,with statistically significant differences(P<0.05).The difference in fracture healing time between the two groups was not statistically significant(P>0.05).Elbow flexion and extension mobility in the observation group was greater than that in the control group at the last follow-up,and the difference was statistically significant(P<0.05).There was no statistically significant difference in forearm pronation mobility and forearm supination mobility between the two groups(P>0.05).The Brobery-Morrey scores of elbow function in the observation group was higher than in the contr

关 键 词：桡骨头骨折 弹性髓内钉 微创 内固定 Mason分型 

分 类 号：R687.3[医药卫生—骨科学]