Lipman Marc D, Gause Trenton M, Teran Victor A, Chhabra A Bobby, Deal D Nicole
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA.
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA.
J Hand Surg Am. 2018 Jun;43(6):575.e1-575.e6. doi: 10.1016/j.jhsa.2018.03.009. Epub 2018 Apr 27.
Radial head and neck fractures are one of the most common elbow fractures, comprising 2% to 5% of all fractures, and 30% of elbow fractures. Although uncomplicated Mason type I fractures can be managed nonsurgically, Mason type II-IV fractures require additional intervention. Mason type II-III fractures with 3 or fewer fragments are typically treated with open reduction and internal fixation using 2 to 3 lag screws. Transverse radial neck involvement or axial instability with screw-only fixation has historically required the additional use of a mini fragment T-plate or locking proximal radius plate. More recently, less invasive techniques such as the cross-screw and tripod techniques have been proposed. The purpose of this paper is to detail and demonstrate the proper implementation of the tripod technique using headless compression screws.
桡骨头和颈部骨折是最常见的肘部骨折之一，占所有骨折的2%至5%，肘部骨折的30%。虽然无并发症的梅森I型骨折可以非手术治疗，但梅森II-IV型骨折需要额外干预。有3个或更少骨折块的梅森II-III型骨折通常采用切开复位并用2至3枚拉力螺钉进行内固定治疗。仅用螺钉固定时，若桡骨颈部有横行骨折或轴向不稳定，历来需要额外使用微型T形钢板或锁定近端桡骨钢板。最近，有人提出了如交叉螺钉和三脚架技术等侵入性较小的技术。本文的目的是详细介绍并演示使用无头加压螺钉正确实施三脚架技术。
