Akman Yunus Emre, Sukur Erhan, Circi Esra, Ozyalvac Osman Nuri, Ozyer Fatih, Ozturkmen Yusuf
Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.
Istanbul Education and Research Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2017 Mar;51(2):118-122. doi: 10.1016/j.aott.2016.03.010. Epub 2017 Jan 5.
The aim of this study was to retrospectively compare a series of patients surgically treated with ORIF or early resection arthroplasty due to isolated comminuted radial head fractures.
Between the years 2009 and 2013, 34 patients with isolated comminuted fractures of the radial head (Mason Type 3) had been operated (ORIF in 19 patients, resection arthroplasty in 15 patients). The mean age of the patients in the ORIF group was 38.5 years and 54 years in the resection group. The carrying angle (CA) and ulnar variance were measured bilaterally, and radiographs were reviewed for degenerative elbow arthritis. The Mayo elbow performance score, Turkish version of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH-T) and visual analog scale (VAS) were used to evaluate the clinical results.
The mean follow-up period in the ORIF group was 40.2 months and 44.4 months in the resection group. In the ORIF group, 11 patients were clinically rated excellent, six good, and two fair. In the resection group, seven patients had excellent, five had good, and two had fair scores. We did not find a statistically significant difference between the ORIF and resection groups regarding the clinical and radiological outcomes.
With these short-term results, resection arthroplasty may be considered an effective method in the treatment of isolated comminuted radial head fractures, as it is less technically demanding and it also allows for early postoperative motion. However, the patients should be evaluated in detail, regarding ligamentous injuries prior to resection arthroplasty.
Level III, Therapeutic study.
本研究旨在回顾性比较一系列因单纯粉碎性桡骨头骨折接受切开复位内固定术（ORIF）或早期切除关节成形术治疗的患者。
2009年至2013年间，34例单纯桡骨头粉碎性骨折（Mason 3型）患者接受了手术治疗（19例接受切开复位内固定术，15例接受切除关节成形术）。切开复位内固定术组患者的平均年龄为38.5岁，切除组为54岁。双侧测量携带角（CA）和尺骨变异，并复查X线片以评估肘关节退行性关节炎。采用梅奥肘关节功能评分、土耳其版上肢、肩部和手部功能障碍问卷（DASH-T）和视觉模拟量表（VAS）评估临床结果。
切开复位内固定术组的平均随访时间为40.2个月，切除组为44.4个月。切开复位内固定术组中，11例患者临床评定为优，6例为良，2例为中。切除组中，7例患者为优，5例为良，2例为中。在临床和影像学结果方面，我们未发现切开复位内固定术组与切除组之间存在统计学显著差异。
基于这些短期结果，切除关节成形术可被视为治疗单纯粉碎性桡骨头骨折的有效方法，因为其技术要求较低，且术后可早期活动。然而，在进行切除关节成形术前，应详细评估患者的韧带损伤情况。
III级，治疗性研究。
