Koslowsky Thomas C, Mader Konrad, Gausepohl Thomas, Pennig Dietmar
Department of Surgery, St. Elisabeth Hospital, Cologne, Germany.
Acta Orthop. 2007 Feb;78(1):151-6. doi: 10.1080/17453670610013565.
Treatment options in radial head fractures of Mason types III and IV range from open reduction and internal fixation (ORIF) to radial head resection with or without prosthetic replacement.
In a prospective study, the radiographic and clinical outcome was evaluated in 23 patients (age median 51 years) with 23 complex radial head fractures median 2 (1-4) years after ORIF using a new fixation device (FFS; Orthofix). 14 Mason type-III fractures with 2 concomitant olecranon fractures and 1 ulnar nerve lesion, and 11 type-IV fractures with 2 olecranon fractures and 2 fractures of the coronoid process were treated. 2 patients were lost to follow-up. In 7 cases of joint instability, an elbow fixator with motion capacity was applied after ORIF of the radial head.
No radial head resection was necessary. No secondary dislocations or nonunion occurred. The Morrey elbow score was excellent in 8 and good in 4 Mason type-III fractures and excellent in 5, good in 3, and fair in 3 Mason type-IV fractures.
Reconstruction of comminuted radial head fractures can be performed with this device and radial head resection can be avoided.
梅森III型和IV型桡骨头骨折的治疗选择范围从切开复位内固定（ORIF）到桡骨头切除并可选择是否进行假体置换。
在一项前瞻性研究中，对23例患者（年龄中位数51岁）的23处复杂桡骨头骨折进行了影像学和临床结果评估，这些骨折在使用新型固定装置（FFS；奥索）进行切开复位内固定术后中位时间为2（1 - 4）年。治疗了14例梅森III型骨折，其中伴有2例尺骨鹰嘴骨折和1例尺神经损伤，以及11例IV型骨折，其中伴有2例尺骨鹰嘴骨折和2例冠突骨折。2例患者失访。在7例关节不稳定的病例中，在桡骨头切开复位内固定术后应用了具有活动能力的肘关节固定器。
无需进行桡骨头切除。未发生继发性脱位或骨不连。在梅森III型骨折中，8例的莫雷肘关节评分优秀，4例良好；在梅森IV型骨折中，5例优秀，3例良好，3例一般。
使用该装置可对粉碎性桡骨头骨折进行重建，避免桡骨头切除。
