Lindemann-Sperfeld L, Jansch L, Genest M, Haferkorn K, Marintschev I, Otto W
Universitätsklinik für Unfall- und Wiederherstellungschirurgie der Martin-Luther-Universität Halle-Wittenberg an den BG-Kliniken Bergmannstrost, Halle/Saale, Germany.
Zentralbl Chir. 2002 Mar;127(3):218-33. doi: 10.1055/s-2002-24254.
The therapeutic regimen of radial head fractures, especially of displaced and comminuted types is controversial. The radial head resection has been critically reviewed over the past years. From 1984-1993 and 1996-1999, 105 radial head fractures were treated in our hospital. 74 were subject to clinical and radiological follow-up. Fracture-types were classified according to Mason. Undisplaced fractures were treated conservatively, displaced 2-fragment-fractures by an open reduction and screw fixation, and multifragment-fractures by a radial head resection. The results were studied on a functional and radiological basis using the "Functional Rating Index" of Broberg and Morrey and the radiological Score of Albrecht and Ganz. After conservative therapy over 80 % achieved excellent and good as well as 12.5 % satisfactory and 6.3 % unsatisfactory results. After reduction and internal fixation again 80 % had excellent and good results. After radial head resection excellent and good results were achieved in 54.6 % of the cases, satisfactory results in 24.2 % and in 21.2 % unsatisfactory results, however prognosis-influencing concomitant injuries were often present in the latter group. Using the right indication and technique, the radial head resection still is a recommendable therapeutic procedure with an altogether good prognosis. This especially applies to isolated radial head fractures where excellent and good results can be achieved in approximately 70 %.
桡骨头骨折，尤其是移位和粉碎性骨折的治疗方案存在争议。在过去几年中，对桡骨头切除术进行了严格审查。1984年至1993年以及1996年至1999年期间，我院共治疗了105例桡骨头骨折。其中74例接受了临床和影像学随访。骨折类型根据梅森（Mason）分类法进行分类。无移位骨折采用保守治疗，移位的两部分骨折采用切开复位螺钉内固定，多部分骨折则采用桡骨头切除术。使用布罗伯格（Broberg）和莫里（Morrey）的“功能评分指数”以及阿尔布雷希特（Albrecht）和甘茨（Ganz）的影像学评分，从功能和影像学方面对结果进行了研究。保守治疗后，超过80%的患者取得了优和良的结果，12.5%的患者结果满意，6.3%的患者结果不满意。切开复位内固定后，80%的患者取得了优和良的结果。桡骨头切除术后，54.6%的病例取得了优和良的结果，24.2%的病例结果满意，21.2%的病例结果不满意，然而后一组患者中常伴有影响预后的合并伤。采用正确的适应证和技术，桡骨头切除术仍是一种值得推荐的治疗方法，总体预后良好。这尤其适用于单纯桡骨头骨折，约70%的患者可取得优和良的结果。
