Zwingmann J, Bode G, Hammer T, Südkamp N P, Strohm P C
Department of Orthopaedic and Trauma Surgery, University of Freiburg Medical Centre, Freiburg, Germany.
Acta Chir Orthop Traumatol Cech. 2015;82(3):177-85.
Due to the elbow joint's complex functional anatomy, the multifragmentary nature of many fractures and concomitant destabilizing associated injuries, dislocated fractures of the radial head and neck still present a serious challenge for the orthopedic surgeon. Thorough knowledge of the elbow's anatomy and biomechanics is essential to analyze and understand the injury and plan its treatment. The aim of a differentiated therapy approach is to restore the joint's anatomy and kinetics, stable and painless joint function, and to avoid or at least delay posttraumatic joint changes. The degree of dislocation, stability of fragments, size and number of fractured joint surfaces and associated bony and ligamentous injuries (and the instability they incur) must be addressed in the therapy regimen. There are various treatment options depending on the injury's classification, i.e. a Mason I fracture is treated conservatively, while more severe injuries may require osteosynthesis and endoprosthesis. There is a lack of clear therapy recommendations based on solid evidence regarding Mason classification types III-IV. In particular expert opinions diverge and study results are inconsistent. Especially the value of radial head arthroplasty is still hotly debated. Key words: radial head fracture, radial head prosthesis, radial neck fracture, Mason classification, radial head arthroplasty, elbow injury.
由于肘关节功能解剖结构复杂，许多骨折呈多碎片性质且伴有破坏稳定性的相关损伤，桡骨头和颈的脱位骨折对骨科医生来说仍是一项严峻挑战。全面了解肘关节的解剖结构和生物力学对于分析和理解损伤情况并制定治疗方案至关重要。差异化治疗方法的目的是恢复关节的解剖结构和动力学、实现稳定且无痛的关节功能，并避免或至少延缓创伤后关节变化。治疗方案必须考虑脱位程度、碎片稳定性、骨折关节面的大小和数量以及相关的骨和韧带损伤（及其导致的不稳定性）。根据损伤的分类有多种治疗选择，即梅森I型骨折采用保守治疗，而更严重的损伤可能需要进行骨固定和使用假体。对于梅森III - IV型分类，缺乏基于确凿证据的明确治疗建议。特别是专家意见存在分歧，研究结果也不一致。尤其是桡骨头置换术的价值仍备受争议。关键词：桡骨头骨折、桡骨头假体、桡骨颈骨折、梅森分类、桡骨头置换术、肘关节损伤
