SPIN螺钉治疗成人MasonⅡ型桡骨小头骨折-东南大学学报医学版

SPIN螺钉治疗成人MasonⅡ型桡骨小头骨折

单位：南京医科大学附属南京第一医院骨科, 江苏南京 210006

分类号：R683.41; R687.32

出版年·卷·期（页码）：2009·28·第三期（225-227）

摘要：

目的: 研究MasonⅡ型桡骨小头骨折切开复位SPIN 螺钉内固定与保守治疗两种方法的临床疗效以及对肘关节功能的影响。方法: 临床随访MasonⅡ型桡骨小头骨折患者58例,保守治疗组28例石膏固定3~4周后开始功能锻炼,手术治疗组30例术后1周进行功能锻炼。术后定期X线复查,采用Broberg和Morrey肘关节功能评分标准评判疗效,并进行统计学分析。结果: 随访15~33个月,平均22个月。保守治疗组Broberg和Morrey 肘关节功能评分优良率75%,有轻、中度疼痛者7例,肌力下降者3例,前臂旋转活动受限者2例,术后X线复查有2例患者发生桡骨小头骨折不同程度的移位;手术治疗组优良率96.7%,留有轻微活动痛3例,无明显关节活动受限及肌力下降。两组疗效差异有统计学意义(P <0.05)。结论: MasonⅡ型桡骨小头骨折采用SPIN螺钉进行内固定治疗,固定骨折块,精确重建关节面,保证了早期的功能锻炼,有助于恢复良好的肘关节功能及前臂旋转功能,是一种较好的治疗方法。

Objective To evaluate and compare the results of conservative treatment methods with those of open reduction and internal fixation with SPIN screws in patients with Mason type-Ⅱ radial head fractures to find out the effect to the elbow joint.Methods A series of 58 patients were followed up.28 patients in conservative treatment group were treated with 3 or 4 weeks of long arm cast immobilization followed by rehabilitation.30 patients underwent open reduction and internal fixation with SPIN screws.Elbow function was assessed adopting Broberg and Morrey elbow score.The results were statistically analyzed,with a P value less than 0.05 indicating significant difference.Results The average follow up period was 22 months.The percentage of excellent and good results was 75% in conservative treatment group and the percentage of excellent and good results was 96.7% in the SPIN screws fixation group.The patients in whom the Mason type-Ⅱ radial head fractures were treated with open reduction and internal fixation with SPIN screws had satisfactory joint motion,with greater strength and better function than the patients who had undergone conservative treatment.Conclusion The treatment of open reduction and internal fixation with SPIN screws for Mason type Ⅱ radial head fractures can remarkably get the better elbow function than conservative treatment.

参考文献：

[1] BANO K Y,KAHLON R S.Radial head fractures—advanced techniques in surgical management and rehabilitation[J].J Hand Ther,2006,19(2):114-135.
[2] MULLER M C,BURGER C,STRIEPENS N,et al.Clinical results after replacement of comminuted radial head fractures (Mason Ⅲ and Ⅳ) by the bipolar radial head prosthesis of Jude[J].Z Orthop Unfall,2008,146(2):218-226.
[3] 王亦璁.骨与关节损伤[M].北京:人民卫生出版社,2003:619-620.
[4] 张丹力,蒋协远,王满宜,等.桡骨头骨折的手术内固定治疗[J].中华创伤骨科杂志,2002,4:227-231.
[5] BOULAS H J,MORREY B F.Biomechanical evaluation of the elbow following radial head fracture.Comparison of open reduction and internal fixation vs.excision,silastic replacement,and non-operative management[J].Chir Main,1998,17:314-320.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录