小切口治疗桡骨头骨折疗效分析
|
摘要
目的探讨小切口治疗单纯桡骨头骨折的临床疗效。方法对2016年1月至2016年12月我院收治的18例Mason II型伴前臂旋转受限的桡骨头骨折患者,采用小切口复位螺钉固定术进行治疗,其中男11例,女7例,年龄18～63岁,平均(37.8±12.1)岁;左侧8例,右侧10例。术后18个月根据Broberg&Morrey评分标准评定肘关节功能。结果 18例术后均获18～24个月,平均19个月随访。平均手术时间35 min (25～50 min),伤口平均长度为2.5 cm (2.0～3.2 cm)。本组均在术后3个月内愈合,愈合时间为4～10周,平均9.8周。术后18个月Broberg&Morrey评分:优12例,良6例,优良率为100%。患者均未发生伤口感染、神经损伤、骨折移位及内固定失效等并发症。结论小切口治疗桡骨头骨折可获得满意的治疗效果,值得临床推广。
Objective To evaluate the results of mini-incision for radial head fractures. Methods A total of 18 patients with Mason type II fracture associated with restricted forearm rotation were treated with screw fixation through mini-incision at our department from Jan 2016 to Dec 2016. There were 11 males and 7 females, aged 18-63 years (average: 37.8 ± 12.1 years). Left elbow was involved in 8 patients and right in 10. The elbow function was evaluated by the Broberg & Morrey scoring system at 18 months postoperatively. Results All patients were followed up for an average of 19 months (range: 18-24 months). The average duration of operation was 35 minutes (range:25-50 minutes). All fractures healed within 3 months. Healing time raged 4-10 weeks (mean: 9.8 weeks). By the Broberg & Morrey scores at 18 months postoperatively, 12 patients were rated as excellent, 6 as good, giving an excellent to good rate of 100%. No wound infection, nerve injury, fracture displacement or fixation failure occurred.Conclusions Treatment of radial head fracture through a mini-incision can achieve satisfactory outcomes. It should be promoted in clinic.
Objective To evaluate the results of mini-incision for radial head fractures. Methods A total of 18 patients with Mason type II fracture associated with restricted forearm rotation were treated with screw fixation through mini-incision at our department from Jan 2016 to Dec 2016. There were 11 males and 7 females, aged 18-63 years (average: 37.8 ± 12.1 years). Left elbow was involved in 8 patients and right in 10. The elbow function was evaluated by the Broberg & Morrey scoring system at 18 months postoperatively. Results All patients were followed up for an average of 19 months (range: 18-24 months). The average duration of operation was 35 minutes (range:25-50 minutes). All fractures healed within 3 months. Healing time raged 4-10 weeks (mean: 9.8 weeks). By the Broberg & Morrey scores at 18 months postoperatively, 12 patients were rated as excellent, 6 as good, giving an excellent to good rate of 100%. No wound infection, nerve injury, fracture displacement or fixation failure occurred.Conclusions Treatment of radial head fracture through a mini-incision can achieve satisfactory outcomes. It should be promoted in clinic.
引文
[1]Court-Brown CM,Caesar B.Epidemiology of adult fractures:a review[J].Injury,2006,37(8):691-697.
[2]Court-Brown CM,Aitken SA,Forward D,et al.The epidemiology of fractures.In:Bucholz RW,Court-Brown CM,Heckman JD,Tornetta P,eds.In:Rockwood and Green’s fractures in adults.Seventh ed.Philadelphia:Lippincott,Williams and Wilkins.2010:53-84.
[3]Duckworth AD,Clement ND,Jenkins PJ,et al.The epidemiology of radial head and neck fractures[J].J Hand Surg Am,2012,37(1):112-119.
[4]Ring D,Quintero J,Jupiter JB.Open reduction and internal fixation of fractures of the radial head[J].J Bone Joint Surg Am,2002,84(10):1811-1815.
[5]Ring D.Elbow fractures and dislocations.In:Bucholz RW,Court-Brown CM,HeckmanJD,et al,eds.Rockwood and Green’s fractures in adults[M].7th ed.Vol 1.New York:Lippincott Williams and Wilkins.2009:905-944.
[6]Bryce CD,Armstrong AD.Anatomy and biomechanics of the elbow[J].Orthop Clin North Am,2008,39(2):141-154.
[7]Morrey BF,Tanaka S,An KN.Valgus stability of the elbow.Adefinition of primary and secondary constraints[J].Clin Orthop Relat Res,1991,(265):187-195.
[8]Smith AM,Morrey BF,Steinmann SP.Low profile fixation of radial head and neck fractures:surgical technique and clinical experience[J].J Orthop Trauma,2007,21(10):718-724.
[9]Li SL,Lu Y,Wang MY.Is cross-screw fixation superior to plate for radialneck fractures[J]?J Bone Joint,2015,97(6):830-835.
[10]鲁谊,李绍良,王满宜.交叉螺钉固定法治疗桡骨颈骨折[J].中华创伤骨科杂志,2015,17(7):575-578.
[2]Court-Brown CM,Aitken SA,Forward D,et al.The epidemiology of fractures.In:Bucholz RW,Court-Brown CM,Heckman JD,Tornetta P,eds.In:Rockwood and Green’s fractures in adults.Seventh ed.Philadelphia:Lippincott,Williams and Wilkins.2010:53-84.
[3]Duckworth AD,Clement ND,Jenkins PJ,et al.The epidemiology of radial head and neck fractures[J].J Hand Surg Am,2012,37(1):112-119.
[4]Ring D,Quintero J,Jupiter JB.Open reduction and internal fixation of fractures of the radial head[J].J Bone Joint Surg Am,2002,84(10):1811-1815.
[5]Ring D.Elbow fractures and dislocations.In:Bucholz RW,Court-Brown CM,HeckmanJD,et al,eds.Rockwood and Green’s fractures in adults[M].7th ed.Vol 1.New York:Lippincott Williams and Wilkins.2009:905-944.
[6]Bryce CD,Armstrong AD.Anatomy and biomechanics of the elbow[J].Orthop Clin North Am,2008,39(2):141-154.
[7]Morrey BF,Tanaka S,An KN.Valgus stability of the elbow.Adefinition of primary and secondary constraints[J].Clin Orthop Relat Res,1991,(265):187-195.
[8]Smith AM,Morrey BF,Steinmann SP.Low profile fixation of radial head and neck fractures:surgical technique and clinical experience[J].J Orthop Trauma,2007,21(10):718-724.
[9]Li SL,Lu Y,Wang MY.Is cross-screw fixation superior to plate for radialneck fractures[J]?J Bone Joint,2015,97(6):830-835.
[10]鲁谊,李绍良,王满宜.交叉螺钉固定法治疗桡骨颈骨折[J].中华创伤骨科杂志,2015,17(7):575-578.