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使用新型植入物治疗粉碎性Mason II型桡骨头骨折的临床和影像学结果

Clinical and radiographic outcomes of treatment of comminuted Mason type II radial head fractures with a new implant.

作者信息

Shi Yan, Wang Gao-Feng, Mei Kai, Zhang Jie, Yun Chang-Jun, Qian Chen, Sun Jun-Ying

机构信息

Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou Department of Orthopaedic Surgery, The Affiliated Wujin Hospital of Jiangsu University, Changzhou, China.

出版信息

Medicine (Baltimore). 2018 Mar;97(13):e0086. doi: 10.1097/MD.0000000000010086.

Abstract

This study aims to evaluate the clinical and radiographic treatment outcomes of comminuted Mason type II radial head fractures, which underwent open reduction and internal fixation (ORIF) using a new implant (mother-child screw, MCS).This study included 16 patients (7 male and 9 female patients; mean age: 40.9 years, age range: 19-68 years), who were treated with ORIF, followed by MCS fixation for comminuted type II radial head fractures. The clinical results were evaluated using the Mayo Elbow Performance Score (MEPS). Radiographs, which included the quality of fracture reduction, stability, osteoarthritis, and heterotopic ossification of the elbow, were investigated. The mean follow-up period was 23.4 months.Anatomical reduction and bone union were achieved in all patients treated with MCS, and mean union time was 6.2 weeks. The average flexion-extension arc of elbow motion was 135.6° (range: 125°-150°), and the average arc of forearm rotation was 155.3° (range: 145°-170°). Furthermore, MEPS was 94.1 (range: 85-100), and the rate of excellent and good was 100%. All patients returned to preinjury work within a mean period of 11.7 weeks. No heterotopic ossification and joint stiffness of the elbow were encountered. Two patients had mild arthritic changes (grade I), but none of these patients complained of pain.The use of MCS fixation for comminuted type II radial head fractures resulted in good clinical and radiographic outcomes.

摘要

本研究旨在评估采用新型植入物(子母螺钉,MCS)进行切开复位内固定(ORIF)治疗的粉碎性Mason II型桡骨头骨折的临床和影像学治疗效果。本研究纳入了16例患者(7例男性和9例女性患者;平均年龄:40.9岁,年龄范围:19 - 68岁),这些患者接受了ORIF治疗,随后采用MCS固定粉碎性II型桡骨头骨折。使用梅奥肘关节功能评分(MEPS)评估临床结果。对包括骨折复位质量、稳定性、骨关节炎以及肘关节异位骨化情况的X线片进行了研究。平均随访期为23.4个月。所有接受MCS治疗的患者均实现了解剖复位和骨愈合,平均愈合时间为6.2周。肘关节屈伸活动平均弧度为135.6°(范围:125° - 150°),前臂旋转平均弧度为155.3°(范围:145° - 170°)。此外,MEPS为94.1(范围:85 - 100),优良率为100%。所有患者在平均11.7周内恢复到伤前工作状态。未出现肘关节异位骨化和关节僵硬情况。2例患者有轻度关节炎改变(I级),但这些患者均无疼痛主诉。采用MCS固定粉碎性II型桡骨头骨折可取得良好的临床和影像学效果。

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