中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2009年
6期
535-538
,共4页
张培训%徐海林%陈建海%薛峰%党育%杨明%王天兵%张殿英%傅中国%张宏波%姜保国
張培訓%徐海林%陳建海%薛峰%黨育%楊明%王天兵%張殿英%傅中國%張宏波%薑保國
장배훈%서해림%진건해%설봉%당육%양명%왕천병%장전영%부중국%장굉파%강보국
桡骨骨折%骨折固定术,内%关节成形术,置换%桡骨小头
橈骨骨摺%骨摺固定術,內%關節成形術,置換%橈骨小頭
뇨골골절%골절고정술,내%관절성형술,치환%뇨골소두
Radius fractures%Fracture fixation,internal%Arthroplasty,replacement%Ra-dial head
目的 根据桡骨小头骨折的不同类型,分别采用切开复位内固定、桡骨头切除、人工桡骨小头置换等方法治疗桡骨小头骨折,并分析其疗效,总结适宜的桡骨小头骨折治疗策略.方法回顾分析1999年11月-2008年5月收治的48例桡骨头骨折(47例患者)的临床资料,其中保守治疗9例(均为Mason Ⅰ型);切开复位内固定治疗28例(Mason Ⅰ型1例,Mason Ⅱ型14例,Mason Ⅲ型13例);桡骨小头切除8例(Mason Ⅲ型3例,Mason Ⅳ型5例);桡骨小头置换3例(Mason Ⅳ型).结果 平均随访2.6年(1～4.4年),2例桡骨小头置换分别随访6个月和3个月.按照Mayo肘关节功能评分评价其疗效,保守治疗优良率为8/9,切开复位内固定优良率为82%(23/28),桡骨头切除优良率为6/8,人工假体置换优良率为3/3.结论 桡骨小头骨折应该尽量达到解剖复位以方便早期的功能锻炼.Mason Ⅰ型骨折町以采用保守治疗;MasonⅡ型、Mason Ⅲ型和部分Mason Ⅳ型骨折可以采用切开复位内固定治疗;部分Mason Ⅳ型骨折无法通过内固定达到稳定固定的,可以选择单纯桡骨头切除或人工桡骨头假体置换.
目的 根據橈骨小頭骨摺的不同類型,分彆採用切開複位內固定、橈骨頭切除、人工橈骨小頭置換等方法治療橈骨小頭骨摺,併分析其療效,總結適宜的橈骨小頭骨摺治療策略.方法迴顧分析1999年11月-2008年5月收治的48例橈骨頭骨摺(47例患者)的臨床資料,其中保守治療9例(均為Mason Ⅰ型);切開複位內固定治療28例(Mason Ⅰ型1例,Mason Ⅱ型14例,Mason Ⅲ型13例);橈骨小頭切除8例(Mason Ⅲ型3例,Mason Ⅳ型5例);橈骨小頭置換3例(Mason Ⅳ型).結果 平均隨訪2.6年(1～4.4年),2例橈骨小頭置換分彆隨訪6箇月和3箇月.按照Mayo肘關節功能評分評價其療效,保守治療優良率為8/9,切開複位內固定優良率為82%(23/28),橈骨頭切除優良率為6/8,人工假體置換優良率為3/3.結論 橈骨小頭骨摺應該儘量達到解剖複位以方便早期的功能鍛煉.Mason Ⅰ型骨摺町以採用保守治療;MasonⅡ型、Mason Ⅲ型和部分Mason Ⅳ型骨摺可以採用切開複位內固定治療;部分Mason Ⅳ型骨摺無法通過內固定達到穩定固定的,可以選擇單純橈骨頭切除或人工橈骨頭假體置換.
목적 근거뇨골소두골절적불동류형,분별채용절개복위내고정、뇨골두절제、인공뇨골소두치환등방법치료뇨골소두골절,병분석기료효,총결괄의적뇨골소두골절치료책략.방법회고분석1999년11월-2008년5월수치적48례뇨골두골절(47례환자)적림상자료,기중보수치료9례(균위Mason Ⅰ형);절개복위내고정치료28례(Mason Ⅰ형1례,Mason Ⅱ형14례,Mason Ⅲ형13례);뇨골소두절제8례(Mason Ⅲ형3례,Mason Ⅳ형5례);뇨골소두치환3례(Mason Ⅳ형).결과 평균수방2.6년(1～4.4년),2례뇨골소두치환분별수방6개월화3개월.안조Mayo주관절공능평분평개기료효,보수치료우량솔위8/9,절개복위내고정우량솔위82%(23/28),뇨골두절제우량솔위6/8,인공가체치환우량솔위3/3.결론 뇨골소두골절응해진량체도해부복위이방편조기적공능단련.Mason Ⅰ형골절정이채용보수치료;MasonⅡ형、Mason Ⅲ형화부분Mason Ⅳ형골절가이채용절개복위내고정치료;부분Mason Ⅳ형골절무법통과내고정체도은정고정적,가이선택단순뇨골두절제혹인공뇨골두가체치환.
Objective To treat radial head fractures with open reduction and internal fixation, removal of the radial head and artificial joint replacement based on different fracture types to discuss the outcome of these methods and summarize optimal strategy for treatment of radial head fractures. Meth-ods A retrospective study was done on data of 47 patients with 48 radial head fractures treated in our de-partment from November 1999 to May 2008. Among them, nine patients were treated conservatively (all type Mason Ⅰ fractures), 28 treated with open reduction and internal fixation (one patient with type Ma-son Ⅰ fracture, 14 with type Mason Ⅱ and 13 with type Mason Ⅲ), eight with removal of radial head (three patients with type Mason Ⅲ fractures and five with type Ⅳ) and three with artificial joint replace-ment (all type Mason Ⅳ fractures). Results All patients were followed up for average 2.8 years (1-4.4 years). Two patients treated with artificial joint replacement were followed up for six months and three months respectively. According to the Mayo Elbow Performance Index, the excellence rate was 8/9 in conservative treatment, 82% (23/28) in open reduction and internal fixation, 6/8 in removal of the radial head and 3/3 in artificial joint replacement respectively. Conclusions The radial head fracture should be given anatomical reduction for early functional exercise. Conservative treatment can be used for type Mason Ⅰ fractures, open reduction and internal fixation for type Mason Ⅱ , type Mason Ⅲ fractures and part of type Mason Ⅳ fractures. The removal of radial head or mental prosthesis replacement are al-ternative for parte of type Mason Ⅳ fractures that can not attain stable fixation through open reduction and internal fixation.
