Department of Orthopaedic and Traumatic Surgery, Qingdao University, Qingdao, China.
Department of Orthopaedic and Traumatic Surgery, No. 971 Hospital of the People's Liberation Army (PLA), Qingdao, China.
Orthop Surg. 2019 Oct;11(5):879-885. doi: 10.1111/os.12540. Epub 2019 Sep 18.
To evaluate the outcome of Mason type II radial head fractures treated by intramedullary pinning.
From May 2013 to March 2017, we respectively reviewed 25 patients affected by Mason type II radial head fractures. A total of 12 patients who met criteria for inclusion and exclusion were collected and analyzed. They were all isolated displaced partial articular radial head fractures and treated with intramedullary pinning using titanium elastic nails (TEN). The patients comprised eight men and four women with the mean age of 40 years (range, 21-58 years). The clinical evaluation included the range of motion (ROM) in the elbow, the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH), the visual analogue scale (VAS) for pain rating, and the Mayo Elbow Performance Score (MEPS). Follow-up radiographs to monitor related complications were evaluated as well.
All patients were followed-up with a mean of 21.8 months (range, 12-28 months). The average range of elbow flexion-extension was barely unaffected in the injured side when compared to the uninjured side (139.08° ± 3.14° vs 140.16° ± 3.01°, P = 0.398) as were pronation of the forearm (86.50° ± 2.75° vs 87.83° ± 2.12°, P = 0.197) and supination of the forearm (87.41° ± 2.53° vs 88.17° ± 1.95°, P = 0.425). The MEPS was 93.75 ± 5.28 points (range, 85-100), the QuickDASH revealed good to excellent results with 2.33 ± 4.56 points (range, 0-14), and the VAS for pain was 0.33 ± 0.78 (range, 0-2). Only two patients had a minor complication with constant affection of the superficial branch of radial nerve.
Intramedullary pinning technique in the treatment of Mason type II radial head fractures is minimally traumatic and effective and represents good to excellent results in adults.
评估髓内钉治疗 Mason Ⅱ型桡骨头骨折的疗效。
自 2013 年 5 月至 2017 年 3 月，我们分别回顾了 25 例 Mason Ⅱ型桡骨头骨折患者。共纳入并分析了符合纳入和排除标准的 12 例患者。他们均为孤立性、移位性、部分关节面桡骨头骨折，采用钛弹性钉（TEN）进行髓内固定。患者包括 8 例男性和 4 例女性，平均年龄 40 岁（范围 21-58 岁）。临床评估包括肘部活动范围（ROM）、上肢、肩和手功能丧失残疾问卷（QuickDASH）、疼痛视觉模拟评分（VAS）和 Mayo 肘关节功能评分（MEPS）。同时也评估了随访时的相关并发症。
所有患者平均随访 21.8 个月（范围 12-28 个月）。与健侧相比，患侧肘关节屈伸活动度几乎无明显差异（139.08°±3.14°比 140.16°±3.01°，P=0.398），前臂旋前（86.50°±2.75°比 87.83°±2.12°，P=0.197）和前臂旋后（87.41°±2.53°比 88.17°±1.95°，P=0.425）也无明显差异。MEPS 评分为 93.75±5.28 分（范围 85-100），QuickDASH 评分为 2.33±4.56 分（范围 0-14），疼痛 VAS 评分为 0.33±0.78 分（范围 0-2）。只有 2 例患者出现轻微并发症，即桡神经浅支持续受影响。
髓内钉治疗 Mason Ⅱ型桡骨头骨折创伤小、效果好，成人疗效优良。
