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改良 Metaizeau 技术治疗成人桡骨颈骨折的疗效:改良 Broberg-Morrey 分类的前瞻性研究。

The effectiveness of a modified Metaizeau technique in fixation of adult radial neck fractures: a prospective study with a modification of the Broberg-Morrey classification.

机构信息

Department of Orthopaedics and Traumatology, Grande International Hospital, Kathmandu, Nepal.

Department of Orthopaedics and Traumatology, Grande International Hospital, Kathmandu, Nepal.

出版信息

J Shoulder Elbow Surg. 2018 Mar;27(3):411-417. doi: 10.1016/j.jse.2017.09.035. Epub 2017 Dec 7.

Abstract

BACKGROUND

The incidence of adult radial neck fractures is lower compared with its pediatric counterpart. The literature on adult radial neck fracture management is limited; also, there is a lack of a detailed fracture classification system. In our study, we are evaluating the modified Metaizeau technique for the treatment of adult radial neck fractures. We also describe a modification to the existing fracture classification proposed by Broberg and Morrey to make it more inclusive of different fracture patterns.

MATERIALS AND METHODS

This is a prospective case series in which we included all the patients who presented to us with adult radial neck fractures. We used a modified Metaizeau technique to treat these fractures. Postoperatively, patients were followed up for a minimum duration of 1 year with a visual analog scale score, the Mayo Elbow Performance Score, the Oxford Elbow Score, the Disabilities of the Arm, Shoulder, and Hand score, and a subjective satisfaction questionnaire.

RESULTS

We included a total of 7 patients who had completed follow-up of 1 year. Of the total 7 cases, 3 cases had an associated radial head fracture (undisplaced), and 1 had an associated radial shaft fracture (segmental pattern). Elastic nails were removed at 6 weeks, and all fractures united. The subjects returned to their preinjury activity levels by the end of 3 months and had excellent outcomes as measured by various outcome scores.

CONCLUSION

The modified Metaizeau technique for closed reduction and internal fixation of adult radial neck fractures is effective and simple and has no complications compared with other treatment methods. However, further studies with larger sample sizes are needed to arrive at a more meaningful conclusion.

摘要

背景

成人桡骨颈骨折的发病率低于儿童桡骨颈骨折。成人桡骨颈骨折的治疗文献有限;此外,还缺乏详细的骨折分类系统。在我们的研究中,我们评估了改良 Metaizeau 技术治疗成人桡骨颈骨折的效果。我们还对 Broberg 和 Morrey 提出的现有骨折分类进行了修改,使其更能包含不同的骨折模式。

材料和方法

这是一项前瞻性病例系列研究,我们纳入了所有因成人桡骨颈骨折就诊的患者。我们使用改良 Metaizeau 技术治疗这些骨折。术后,患者至少随访 1 年,采用视觉模拟评分、 Mayo 肘关节功能评分、牛津肘关节评分、手臂、肩部和手部残疾评分以及主观满意度问卷进行随访。

结果

我们共纳入了 7 例完成 1 年随访的患者。在这 7 例中,有 3 例合并桡骨头骨折(无移位),1 例合并桡骨骨干骨折(节段性)。弹性钉在 6 周时取出,所有骨折均愈合。患者在 3 个月内恢复到伤前的活动水平,各项功能评分均显示出极好的效果。

结论

与其他治疗方法相比,改良 Metaizeau 技术用于闭合复位和内固定成人桡骨颈骨折是有效和简单的,且无并发症。但是,需要更大样本量的研究来得出更有意义的结论。

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