Schmidt-Horlohé K, Buschbeck S, Wincheringer D, Weißenberger M, Hoffmann R
Abteilung für Unfallchirurgie und Orthopädische Chirurgie, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main gGmbH, Friedberger Landstraße 430, 60389, Frankfurt am Main, Deutschland.
Orthopaedicum Wiesbaden, Friedrichstraße 29, 65185, Wiesbaden, Deutschland.
Orthopade. 2016 Oct;45(10):853-60. doi: 10.1007/s00132-016-3330-1.
Radial head fractures are common injuries in elbow trauma. Non-displaced fractures are best treated conservatively. Simple but displaced fractures require anatomic reduction and fixation, typically using screws. The treatment course for complex fractures with multiple fragments is still being debated, as results are less predictable. Radial head resection is not advised if concomitant injuries of the coronoid process or the collateral ligaments with instability are present. Favorable outcomes following open reduction and fixation using plates were reported recently. However, complication rates are very high. Radial head replacement is a valuable tool in treating complex fractures of the radial head with predominantly good and excellent results. Patients who suffer radial head fractures are typically of a younger age, resulting in high functional demands. Certainly, unspecific and specific complications related to radial head arthroplasty were reported in up to 40 % of cases in an acute fracture setting. This article highlights common complications in radial head arthroplasty and aims to present strategies to avoid them.
桡骨头骨折是肘部创伤中的常见损伤。无移位骨折最好采用保守治疗。简单的移位骨折需要解剖复位和固定，通常使用螺钉。对于多块碎片的复杂骨折，其治疗方案仍存在争议，因为结果较难预测。如果存在冠状突或侧副韧带合并损伤且伴有不稳定情况，则不建议进行桡骨头切除术。最近有报道称使用钢板切开复位内固定术后效果良好。然而，并发症发生率非常高。桡骨头置换是治疗桡骨头复杂骨折的一种有效手段，多数情况下效果良好。桡骨头骨折患者通常较为年轻，对功能要求较高。当然，在急性骨折情况下，高达40%的病例报告了与桡骨头置换术相关的非特异性和特异性并发症。本文重点介绍桡骨头置换术中的常见并发症，并旨在提出避免这些并发症的策略。
