Harbrecht A, Ott N, Hackl M, Leschinger T, Wegmann K, Müller L P
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Schwerpunkt für Unfall‑, Hand- und Ellenbogenchirurgie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Unfallchirurg. 2021 Feb;124(2):153-162. doi: 10.1007/s00113-020-00947-8.
Radial head fractures account for the majority of bony injuries to the elbow. The usual clinical signs include hemarthrosis, pain and limitations in movement. The standard diagnostic tool is radiological imaging using X‑rays and for more complex fractures, computed tomography (CT). Concomitant ligamentous injuries occur more frequently than expected and must be reliably excluded. The classification is based on the modified Mason classification. Mason type I fractures are usually treated conservatively with immobilization and early functional aftercare. Mason type II fractures can be well-addressed by screw osteosynthesis but higher grade fractures (Mason types III-IV) can necessitate a prosthetic radial head replacement. In this case, prosthesis implantation is to be preferred to a radial head resection. The outcome after treatment of radial head fractures can be described as good to very good if all accompanying injuries are adequately addressed.
桡骨头骨折占肘部骨损伤的大多数。常见的临床体征包括关节积血、疼痛和活动受限。标准的诊断工具是使用X射线进行放射成像,对于更复杂的骨折,则使用计算机断层扫描(CT)。合并的韧带损伤比预期更常见,必须可靠地排除。分类基于改良的梅森分类法。梅森I型骨折通常采用固定和早期功能后期护理的保守治疗。梅森II型骨折可以通过螺钉接骨术得到很好的治疗,但更高等级的骨折(梅森III-IV型)可能需要进行人工桡骨头置换。在这种情况下,假体植入优于桡骨头切除术。如果所有伴随损伤都得到妥善处理,桡骨头骨折治疗后的结果可以描述为良好至非常好。