手术与非手术治疗MasonⅡ型桡骨头骨折的疗效比较  

Operative versus nonoperative treatment of isolated Mason typeⅡradial head fracture

作　　者：李长润 李庭 孙志坚 米萌 肖鸿鹄 季尚蔚 姚东辰 段芳芳 蒋协远 Li Changrun;Li Ting;Sun Zhijian;Mi Meng;Xiao Honghu;Ji Shangwei;Yao Dongchen;Duan Fangfang;Jiang Xieyuan(Department of Trauma and Orthopaedics,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Clinical Epidemiology Research Center,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院创伤骨科,北京100035 [2]首都医科大学附属北京积水潭医院临床流行病学研究室,北京100035

出　　处：《中华创伤骨科杂志》2023年第8期670-675,共6页Chinese Journal of Orthopaedic Trauma

基　　金：北京市百千万人才工程培养经费资助(2020A45)。

摘　　要：目的比较手术与非手术治疗MasonⅡ型桡骨头骨折的疗效。方法回顾性分析2017年1月至2020年10月期间北京积水潭医院创伤骨科采用手术和非手术治疗MasonⅡ型桡骨头骨折患者的资料,根据治疗方式将患者分为非手术组和手术组,采用倾向评分匹配法对两组患者进行1∶1匹配,共58对患者成功匹配。手术组男24例,女34例;年龄为(40±14)岁;体重指数为(23.7±3.4)kg/m2。非手术组男22例,女36例;年龄为(42±13)岁;体重指数为(23.5±3.9)kg/m2。比较两组患者末次随访时患肢肘关节屈伸和前臂旋转范围、Mayo肘关节功能评分(MEPS)、快速上肢功能障碍评分(q-DASH)和并发症发生情况。结果两组患者基线资料比较差异均无统计学意义(P>0.05),具有可比性。所有患者治疗后获(24±9)个月随访。末次随访时手术组与非手术组肘关节屈伸范围分别为134°(132°,136°)、134°(131°,136°),前臂旋转范围分别为176°(174°,179°)、178°(175°,179°),MEPS评分分别为100(100,100)、100(100,100)分,q-DASH评分分别为0(0,0)、0(0,0)分,以上项目两组间比较差异均无统计学意义(P>0.05)。手术组与非手术组分别有4、6例患者出现肘关节疼痛,两组并发症发生率(6.9%vs.10.3%)比较差异无统计学意义(P>0.05)。结论手术与非手术治疗MasonⅡ型桡骨头骨折疗效相当。Objective To compare the outcomes of isolated Mason typeⅡradial head fracture between operative and non-operative treatments.Methods A retrospective study was conducted to analyze the data of patients who had been treated for isolated Mason typeⅡradial head fracture either operatively or nonoperatively at Department of Trauma and Orthopaedics,Beijing Jishuitan Hospital,Capital Medical University from January 2017 to October 2020.The patients were divided into a non-operative group and an operative group according to their treatment method.After 1:1 propensity score matching method was used to match the patients in the 2 groups,a total of 58 pairs of patients were successfully matched.In the operative group,there were 24 males and 34 females with a mean age of(40±14)years and a body mass index of(23.7±3.4)kg/m2;in the non-operative group,there were 22 males and 36 females with a mean age of(42±13)years and a body mass index of(23.5±3.9)kg/m2.Elbow flexion-extension,forearm rotation,Mayo elbow performance score(MEPS),Quick-disabilities of the arm,shoulder and hand(q-DASH)score and complications were compared between the 2 groups.Results There was no significant difference in the baseline data between the 2 groups,indicating comparability(P>0.05).All the patients were followed up for(24±9)months.At the last follow up in the operative and the non-operative groups,respectively,the elbow flexion-extension was 134°(132°,136°)and 134°(131°,136°),the forearm rotation 176°(174°,179°)and 178°(175°,179°),the MEPS 100(100,100)and 100(100,100),the q-DASH score 0(0,0)and 0(0,0),showing no significant differences between the 2 groups in the above items(P>0.05).Elbow pain was reported respectively in 4(6.9%)and 6(10.3%)patients in the operative and non-operative groups,showing no significant difference between the 2 groups(P>0.05).Conclusion The outcomes of operative and non-operative treatments of isolated Mason typeⅡradial head fracture are comparable.

关 键 词：桡骨骨折 肘关节 活动范围 关节 治疗结果 

分 类 号：R687.3[医药卫生—骨科学]