Heim U
AO International, Bern.
Z Unfallchir Versicherungsmed. 1992;85(1):3-11.
Fractures of the radial head are often combined with ligament ruptures or subluxations creating instability of the elbow joint. Cartilage avulsions of the capitellum trapped between the fragments are a frequent observation. We advocate ORIF for displaced fractures. The posterolateral approach avoiding compression of the radial nerve may be prolonged proximally with an osteotomy of the humeral epicondyle giving full overview of the circumference of the head. It allows the harvesting of cancellous bone used as a graft to fill in articular depressed areas or metaphyseal defects. The stabilisation is achieved with thin screws of 1.5 mm diameter introduced in different planes, their head slightly sunken in the cartilage. Lately miniplates have been used in cases of neck fractures with surprisingly good functional results. The author reports about the results in 42 of 49 operated patients.
桡骨头骨折常合并韧带断裂或半脱位，导致肘关节不稳定。常见的情况是，在骨折碎片之间会出现肱骨小头软骨撕脱。对于移位骨折，我们主张切开复位内固定术（ORIF）。可采用后外侧入路，避免压迫桡神经，必要时可通过肱骨髁截骨术将切口向近端延长，从而全面观察桡骨头的圆周情况。该入路还可获取松质骨用于植骨，填充关节凹陷区域或干骺端缺损。通过在不同平面拧入直径1.5毫米的细螺钉实现稳定固定，螺钉头部略沉入软骨。最近，微型钢板已用于治疗桡骨颈骨折，功能效果出奇地好。作者报告了49例手术患者中42例的治疗结果。
