Department of Orthopaedics and Traumatology, Hospital Universitari de Tarragona, Joan XXIII, Rovira and Virgili University, Tarragona, Spain.
J Shoulder Elbow Surg. 2011 Jan;20(1):45-50. doi: 10.1016/j.jse.2010.09.005.
Complex radial head fractures treated by early resection arthroplasty yield good clinical results at long-term follow-up.
Fifty-one radial head excisions were performed for the treatment of radial head fractures. Twenty-seven patients (20 men, 7 women) were retrospectively reviewed. The mean age was 37 (range, 18-61) and their fracture types according to the Mason classification were 5 type II, 16 type III, and 6 type IV. The mean follow-up period was 17 years (range, 10-24). Patients were clinically evaluated: Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), visual analogue scale (VAS) for pain scores, and strength. Degenerative changes, proximal migration of the radius, and carrying angle were measured.
The overall outcome of the MEPS was 96.4 (range, 70-100), 22 patients (81%) achieving an excellent result, 4 patients a good (15%), and 1 patient a fair result (4%). The mean DASH score was 4.89, with slightly better results in the Mason II group than the Mason III and IV patients (P = .15). VAS averaged 0.48 (range, 0-10). Twenty-three patients (85%) reported no pain. The mean range of motion was from 5° to 135°. Pronation averaged 83° and supination averaged 79°. Strength was maintained in 24 cases (88%). In 24 patients, osteoarthritic changes were present without clinical relevance. Proximal migration of the radius was recorded in 7 cases. Carrying angle increased significantly by 7° (15° compared with 8°).
Radial head fractures treated by early resection arthroplasty offer satisfactory functional results in 96% of patients at long-term follow-up, in spite of the radiographic degenerative changes present in the great majority of cases.
对于桡骨头骨折，采用早期切除关节成形术治疗可获得长期随访的良好临床效果。
对 51 例桡骨头切除术治疗桡骨头骨折患者进行回顾性分析。27 例患者（20 例男性，7 例女性），平均年龄 37 岁（范围 18-61 岁），按 Mason 分类，5 例 II 型，16 例 III 型，6 例 IV 型。平均随访时间 17 年（范围 10-24 年）。患者进行临床评估：Mayo 肘关节功能评分（MEPS）、上肢功能障碍评分（DASH）、疼痛视觉模拟评分（VAS）和力量。测量退行性改变、桡骨近端迁移和携带角。
MEPS 的总体结果为 96.4（范围 70-100），22 例（81%）患者获得优秀结果，4 例（15%）良好，1 例（4%）一般。平均 DASH 评分为 4.89，Mason II 组略优于 Mason III 和 IV 组（P=.15）。VAS 平均为 0.48（范围 0-10）。23 例（85%）患者无疼痛。平均活动范围为 5°-135°。旋前平均 83°，旋后平均 79°。24 例（88%）患者保持力量。24 例患者存在骨关节炎改变，但无临床相关性。7 例患者记录到桡骨近端迁移。携带角显著增加 7°（15°与 8°比较）。
桡骨头骨折采用早期切除关节成形术治疗，在长期随访中，96%的患者获得满意的功能结果，尽管大多数病例存在放射学退行性改变。
