CAJ | 학술논문

目的：探讨解剖型桡骨头假体置换治疗桡骨头粉碎性骨折的早期疗效。方法2009年6月至2013年5月，以Acumed解剖型桡骨头假体置换治疗桡骨头粉碎性骨折21例。男15例，女6例；年龄29～52岁，平均32.5岁。左侧8例，右侧13例。桡骨头骨折均为新鲜闭合粉碎性骨折，其中Mason III型8例， Mason IV型6例，肘部损伤“三联征”3例，Essex-Lopresti损伤2例，II型Monteggia骨折脱位2例。受伤至手术的时间平均为6.8(3～14)天。结果21例均获6～38个月，平均18.75个月的随访。未见切口感染、桡神经损伤、假体松动、肘关节不稳、创伤性关节炎等并发症，肘关节功能满意。其中2例遗留肘关节轻度疼痛；5例出现异位骨化，未对肘和前臂的运动造成明显影响。按照Broberg和Morrey肘关节功能评估标准进行功能评定：优10例，良8例，可2例，差1例，优良率为85.7%。结论 Acumed解剖型桡骨头假体置换治疗桡骨头粉碎性骨折有利于恢复肘关节的稳定、伸屈活动及前臂的旋转活动，可获得比较满意的疗效。
목적：탐토해부형뇨골두가체치환치료뇨골두분쇄성골절적조기료효。방법2009년6월지2013년5월，이Acumed해부형뇨골두가체치환치료뇨골두분쇄성골절21례。남15례，녀6례；년령29～52세，평균32.5세。좌측8례，우측13례。뇨골두골절균위신선폐합분쇄성골절，기중Mason III형8례， Mason IV형6례，주부손상“삼련정”3례，Essex-Lopresti손상2례，II형Monteggia골절탈위2례。수상지수술적시간평균위6.8(3～14)천。결과21례균획6～38개월，평균18.75개월적수방。미견절구감염、뇨신경손상、가체송동、주관절불은、창상성관절염등병발증，주관절공능만의。기중2례유류주관절경도동통；5례출현이위골화，미대주화전비적운동조성명현영향。안조Broberg화Morrey주관절공능평고표준진행공능평정：우10례，량8례，가2례，차1례，우량솔위85.7%。결론 Acumed해부형뇨골두가체치환치료뇨골두분쇄성골절유리우회복주관절적은정、신굴활동급전비적선전활동，가획득비교만의적료효。
Objective To explore the early clinical results of anatomic radial head prosthesis replacement in the treatment of comminuted radial head fractures. Methods From June 2009 to May 2013, a total of 21 patients underwent Acumed anatomic radial head prosthesis replacement for comminuted radial head fractures, including 15 men and 6 women, whose mean age was 32.5 years old ( range;29-52 years ). There were 8 cases on the left side and 13 cases on the right side. All were fresh closed fractures. According to the Mason classiifcation, there were 8 cases of type III, 6 cases of type IV, 3 cases of terrible triad injury of the elbow, 2 cases of Essex-Lopresti injury and 2 cases of posterior olecranon fracture-dislocation of Monteggia type II. The operation was performed at 6.8 days after the injury on average ( range;3-14 days ). Results All the patients were followed up for an average period of 18.75 months ( range;6-38 months ). No incision infection, radial nerve injury, prosthetic loosening, elbow instability or traumatic osteoarthritis was found. There were 2 cases of mild pain in the elbow joint. Heterotopic ossiifcation was found in 5 cases, but no distinct limitation of locomotion of the elbow and forearm was noticed. According to the Broberg and Morrey rating system, the results showed 10 excellent cases, 8 good, 2 fair, and 1 poor. The excellent and good rate was 85.7%. Conclusions Acumed anatomic radial head prosthesis replacement is an effective method in the treatment of comminuted radial head fractures, which can better restore the stability, lfexion and extension of the elbow and the rotational motion of the forearm, with satisfactory clinical results.