Zarifian Ahmadreza, Rahimi Shoorin Hassan, Hallaj Moghaddam Mohammad, Fathi Vavsari Meysam, Gharedaghi Mohammad, Moradi Ali
Research performed at Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Orthopedics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Arch Bone Jt Surg. 2018 Sep;6(5):365-370.
Radial head fractures commonly occur during elbow traumas. Among those, treatment of Mason type III fractures is still under controversy. Common treatment methods for these fractures include open reduction and internal fixation (ORIF) as well as radial head excision. In this study, we compared long-term outcomes of both methods in treatment of patients with Mason type III fractures of radial head.
Fifteen men and five women with Mason type III radial head fractures were evaluated retrospectively. Ten patients had undergone excision whereas the other ten patients had been treated with ORIF. Outcomes were assessed based on stability and range of motion of the elbow joint, grip strength, and pain. Data were gathered using Mayo elbow performance index (MEPI), Oxford elbow score, and disability of arm-shoulder-hand (DASH), along with the short form (SF)-36 questionnaire.
The mean age of the subjects was 36.25±9.22 years and the mean follow-up time was 25.05±11.43 months. The ranges of extension and supination, and frequency of pain reporting was significantly different between the groups. The average grip strength in the operated side was significantly higher in the ORIF group, compared with the excision (). Ten (100%) patients of ORIF group and 5 (50%) patients of excision group had elbow joint stability (). Mean MEPI and DASH scores were significantly higher in ORIF group ( and , respectively).
The results are in favor of ORIF method. Therefore, this method is recommended and preferred over excision in treating radial heads with Mason type III fracture.
桡骨头骨折常见于肘部创伤。其中，Mason III型骨折的治疗仍存在争议。这些骨折的常见治疗方法包括切开复位内固定（ORIF）以及桡骨头切除术。在本研究中，我们比较了这两种方法治疗桡骨头Mason III型骨折患者的长期疗效。
回顾性评估15例男性和5例女性桡骨头Mason III型骨折患者。10例患者接受了切除术，另外10例患者接受了切开复位内固定治疗。根据肘关节的稳定性和活动范围、握力和疼痛情况评估疗效。使用梅奥肘关节功能指数（MEPI）、牛津肘关节评分、手臂-肩部-手部功能障碍（DASH）以及简明健康状况调查问卷（SF-36）收集数据。
受试者的平均年龄为36.25±9.22岁，平均随访时间为25.05±11.43个月。两组之间的伸展和旋后范围以及疼痛报告频率存在显著差异。与切除术组相比，切开复位内固定组手术侧的平均握力显著更高（）。切开复位内固定组10例（100%）患者和切除术组5例（50%）患者肘关节稳定（）。切开复位内固定组的平均MEPI和DASH评分显著更高（分别为和）。
结果支持切开复位内固定方法。因此，在治疗桡骨头Mason III型骨折时，推荐并优先选择该方法而非切除术。
