Touloupakis G, Biancardi E, Theodorakis E, Ghirardelli S, Ferrara F, Gherlinzoni F, Antonini G
Department of Orthopaedics and Traumatology, San Carlo Borromeo Hospital, Milan, Italy.
Department of Orthopaedics and Traumatology, AAS 2 Bassa Friulana-Isontina, Gorizia, Italy.
Malays Orthop J. 2020 Nov;14(3):124-128. doi: 10.5704/MOJ.2011.019.
The aim of our retrospective study was to investigate the role of the medial side involvement in the treatment choice of radial head fractures.
We searched the databases of our institutions for the surgical procedures diagnosed as "fracture of the radial head" and for the procedures related to "prosthesis of the radial head" and "osteosynthesis of the radial head" in the period from May 2014 to October 2017. The fractures were first classified according to the Mason classification . We then allocated the patients into three study groups according to the site of the fracture, either the medial or lateral side of the radial head : Group A, with an isolated lateral fracture of the radius head; Group B1, with a medial fracture of the radius head with two medial fragments; and Group B2, with a medial fracture of the radius head with multiple medial fragments. We performed a multivariate analysis to identify statistically significant correlation between the pre-operative classifications of Mason and our study, the type of surgical procedure, and the clinical outcome.
Mayo Elbow Performance (MEP) scores determined at the final follow-up of the study (mean 16.6 months, range 12-26 months) was excellent in 17 patients (4 in Group A, 6 in Group B1 and 7 in Group B2), and good in 12 patients (3 in Group A, 7 in Group B1, and 2 in Group B2). One patient showed a poor result in MEP score probably because of an infection and implant removal.
Regarding medial fractures of the radial head, our study showed satisfactory results with a radial head prosthesis for comminuted or multifragmentary radial head fractures. For surgeons with advanced elbow fracture expertise, osteosynthesis could be attempted in a fracture pattern that involved only two medial fragments.
我们这项回顾性研究的目的是探讨桡骨头内侧受累情况在桡骨头骨折治疗选择中的作用。
我们在2014年5月至2017年10月期间，在我们机构的数据库中搜索诊断为“桡骨头骨折”的手术记录，以及与“桡骨头假体”和“桡骨头骨固定术”相关的记录。骨折首先根据梅森分类法进行分类。然后，我们根据骨折部位，即桡骨头的内侧或外侧，将患者分为三个研究组：A组，孤立的桡骨头外侧骨折；B1组，桡骨头内侧骨折且有两个内侧骨折块；B2组，桡骨头内侧骨折且有多个内侧骨折块。我们进行了多变量分析，以确定梅森术前分类与我们的研究、手术方式类型以及临床结果之间的统计学显著相关性。
在研究的最终随访时（平均16.6个月，范围12 - 26个月）测定的梅奥肘关节功能（MEP）评分中，17例患者为优（A组4例，B1组6例，B2组7例），12例患者为良（A组3例，B1组7例，B2组2例）。1例患者的MEP评分结果较差，可能是由于感染和植入物取出。
关于桡骨头内侧骨折，我们的研究表明，对于粉碎性或多块性桡骨头骨折，使用桡骨头假体可获得满意结果。对于有高级肘关节骨折专业知识的外科医生，对于仅涉及两个内侧骨折块的骨折模式，可尝试进行骨固定术。
