Department of Orthopedics, Sahloul University Hospital, Sousse, Tunisia.
Department of Orthopedics, Sahloul University Hospital, Sousse, Tunisia.
J Shoulder Elbow Surg. 2018 Sep;27(9):1650-1655. doi: 10.1016/j.jse.2018.06.008. Epub 2018 Aug 10.
The treatment of radial neck fractures is controversial and typically depends on displacement. Surgical procedures based on open reduction-internal fixation (ORIF) may lead to several complications, such as avascular necrosis of the radial head, nonunion, malunion, and elbow stiffness. Closed reduction with intramedullary pinning of radial neck fractures, which is commonly used in children, is a viable option for these fractures in adults and may allow for a lower complication rate compared with ORIF. The aim of this study was to report the functional outcome of closed reduction and intramedullary stabilization in isolated radial neck fractures.
Fourteen cases were retrospectively reviewed between January 2007 and December 2016. The inclusion criteria were isolated radial neck fractures of type I to III according to the Mason classification, absence of previous injuries of the elbow, and a minimum of 1 year of follow-up. The Mason classification was used to classify these injuries. At final follow-up, functional assessment was established based on functional scores: Morrey Elbow Score, Elbow Self-Assessment Score, and QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand questionnaire) score. Range of motion was evaluated similarly.
The mean follow-up period was 86 months. The mean age was 44.2 years. Regarding the functional outcome, 78% of patients claimed satisfaction. Concerning the functional scoring, the mean visual analog scale score was 0.2 (range, 0-4) and the mean Morrey Elbow Score was 95.7 (range, 85-100). The mean QuickDASH score was 6.4 (range, 7-22). The complication rate was 35%. Malunion was observed in 7% of patients.
Intramedullary pinning of radial neck fractures represents a viable technique in adults because of its safety and simplicity. The complication rates are lower than those in other reports of ORIF.
桡骨颈骨折的治疗存在争议，通常取决于移位程度。基于切开复位内固定（ORIF）的手术可能会导致多种并发症，如桡骨头缺血性坏死、骨不连、畸形愈合和肘部僵硬。闭合复位髓内针固定桡骨颈骨折，常用于儿童，对于成人这些骨折也是一种可行的选择，与 ORIF 相比，可能会降低并发症发生率。本研究旨在报告闭合复位和髓内固定治疗孤立性桡骨颈骨折的功能结果。
回顾性分析 2007 年 1 月至 2016 年 12 月期间的 14 例病例。纳入标准为 Mason 分类Ⅰ至Ⅲ型孤立性桡骨颈骨折、无肘部既往损伤、随访至少 1 年。采用 Mason 分类对这些损伤进行分类。最终随访时，根据功能评分（Morrey 肘部评分、肘部自我评估评分和 QuickDASH（手臂、肩部和手残疾问卷的简化版）评分）进行功能评估。同样评估了活动范围。
平均随访时间为 86 个月。平均年龄为 44.2 岁。78%的患者对功能结果表示满意。关于功能评分，平均视觉模拟评分（VAS）为 0.2（范围 0-4），平均 Morrey 肘部评分为 95.7（范围 85-100）。平均 QuickDASH 评分为 6.4（范围 7-22）。并发症发生率为 35%。7%的患者出现畸形愈合。
由于其安全性和简单性，髓内针固定桡骨颈骨折在成人中是一种可行的技术。并发症发生率低于其他 ORIF 报告。
