CAJ | 학술논문

[目的] 比较研究Herbert钉、微型空心松质骨螺钉、微型皮质骨螺钉以及克氏针内固定治疗Mason Ⅱ型桡骨头骨折的临床效果.[方法] 1999年1月-2005年7月共收治34例Mason Ⅱ型桡骨头骨折,7例行Herbert钉内固定术(1组),10例行微型空心松质骨螺钉内固定术(2组),9例行微型皮质骨螺钉内固定术(3组), 8例行克氏针内固定术(4组).通过随访对4组患者肘关节的疼痛、功能评分以及运动、肌力、X线表现进行比较研究.[结果] 术后随访2～6年,平均4.5年,4组平均肘关节痛觉满意视觉模拟评分(VAS评分)分别为 24.2、23.7、21.5和19.7分(P< 0.01),平均Broderg和Morrey肘关节功能评分分别为93.3、94.1、91.4和86.3分(P< 0.01);4组患者肘关节伸、屈以及前臂旋前活动度差异有统计学意义(P< 0.01),但伸肘、屈肘肌力以及旋前和旋后肌力差异无显著性(P> 0.01),均正常.[结论] 与克氏针内固定相比,切开复位Herbert钉、微型空心松质骨螺钉以及微型皮质骨螺钉内固定治疗Mason Ⅱ型桡骨头骨折可获得较满意的关节活动范围以及较好的关节功能恢复.
[목적] 비교연구Herbert정、미형공심송질골라정、미형피질골라정이급극씨침내고정치료Mason Ⅱ형뇨골두골절적림상효과.[방법] 1999년1월-2005년7월공수치34례Mason Ⅱ형뇨골두골절,7례행Herbert정내고정술(1조),10례행미형공심송질골라정내고정술(2조),9례행미형피질골라정내고정술(3조), 8례행극씨침내고정술(4조).통과수방대4조환자주관절적동통、공능평분이급운동、기력、X선표현진행비교연구.[결과] 술후수방2～6년,평균4.5년,4조평균주관절통각만의시각모의평분(VAS평분)분별위 24.2、23.7、21.5화19.7분(P< 0.01),평균Broderg화Morrey주관절공능평분분별위93.3、94.1、91.4화86.3분(P< 0.01);4조환자주관절신、굴이급전비선전활동도차이유통계학의의(P< 0.01),단신주、굴주기력이급선전화선후기력차이무현저성(P> 0.01),균정상.[결론] 여극씨침내고정상비,절개복위Herbert정、미형공심송질골라정이급미형피질골라정내고정치료Mason Ⅱ형뇨골두골절가획득교만의적관절활동범위이급교호적관절공능회복.
[Objective]To compare the clinical results of treatment of Mason type-Ⅱ radial head fracture by open reduction and internal fixation with Herbert screw,micro-cannulated screw,micro-cartical screw and Kirschner wire.[Method]Thirty-four cases of Mason type-Ⅱ radial head fracture were treated from Jan.1999 to July 2005.Seven cases had internally fixed with Herbert screws (group 1),10 with micro-cannulated screws ( group 2),9 with micro-cartical screws (group 3),and 8 with Kirschner wires (group 4).The outcomes were assessed with regard to the pain,elbow functional rating score and motion,strength,radiographic findings.[Result]The mean follow-up was 4.5 (2-6)years.The averaged pain VAS score was 24.2,23.7,21.5 and 19.7,respectively,with a P value of 0.0046.And the mean Broberg and Morrey functional rating score was 93.3,94.1,91.4 and 86.3(P＝0.0069).The elbow extension,flexion and the forearm anterior rotation range differed statistically among the 4 groups (P<0.01),but the strength of elbow extension,flexion and forearm rotation showed no statistical difference among the 4 groups(P>0.01).[Conclusion]Compared to internal fixation with wires,open reduction and internal fixation with Herbert screws,micro-cannulated screws and micro-cartical screws can result in more satisfying elbow motion and better functional recovery in treating Mason type-Ⅱ radial head fracture.