Miller George, Humadi Ali, Unni Raghavan, Hau Raphael
Department of Orthopaedic, The Northern Hospital, 185 Cooper St, Epping, Victoria, 3076, Australia.
Indian J Orthop. 2013 Jul;47(4):323-32. doi: 10.4103/0019-5413.114907.
The evidence for optimal management of Mason type III fracture of radial head is unclear hence a systematic review of the published literature was performed in April 2012. This review includes 5 prospective studies (including 2 randomized trials), 4 retrospective studies and 9 case series. No study can be interpreted as level 1 evidence. Level 2 and 3 evidence provides some insight into the success of each modality through subjective and objective measurements of function and complication rates. Radial head replacement, open reduction internal fixation (ORIF) and radial head resection all provide satisfactory outcomes for patients in most cases. One treatment modality cannot be recommended over any other due to the small number of clinical trials and cases included in each study. Further randomized control trials are needed to evaluate the full benefits and shortcomings of each of the different surgical treatment modalities.
桡骨头Mason III型骨折的最佳治疗方案尚无明确证据,因此于2012年4月对已发表的文献进行了系统综述。该综述纳入了5项前瞻性研究(包括2项随机试验)、4项回顾性研究和9个病例系列。没有一项研究可被视为一级证据。二级和三级证据通过对功能和并发症发生率的主观及客观测量,为每种治疗方式的成功率提供了一些见解。在大多数情况下,桡骨头置换、切开复位内固定(ORIF)和桡骨头切除术对患者均能提供满意的疗效。由于每项研究纳入的临床试验和病例数量较少,无法推荐某一种治疗方式优于其他方式。需要进一步开展随机对照试验,以评估每种不同手术治疗方式的全部益处和缺点。