Jia Zhaofeng, Hong Yixia, Li Chuangli, Lin Jiandong, Hu Xinjia
Department of Osteoarthropathy, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University and The First Affiliated Hospital of Southern University of Science and Technology Shenzhen 518035, Guangdong Province, China.
Am J Transl Res. 2021 Nov 15;13(11):12807-12815. eCollection 2021.
Radial head fractures (RHFs) occur most frequently among all elbow fractures. Current treatments pose several limitations for the Mason type II radial head fractures. This study was performed to evaluate the clinical efficacy of a new minimally invasive treatment for Mason type II radial head fractures using intramedullary fixation with double titanium elastic nails. Between January 2018 and December 2019, our group used double titanium elastic intramedullary nails as a minimally invasive treatment for 32 cases of Mason II type radial head fractures. After the treatments, we summarized and conducted a retrospective analysis to evaluate the surgical operation itself, the quality of the fracture reductions, the fracture healing, and any complications. The Mayo elbow function scores (MEPS) and the visual analog scale (VAS) pain scores were used to evaluate the clinical efficacy of this approach. All the patients recovered from their surgeries without any complications. We followed all the cases for an average of 12 months. The elbow extension range of motion was 5 degrees (range: 0-15 degrees), the elbow flexion range of motion was 140 degrees (range: 135-146 degrees), and the average forearm pronation range of motion was 84.1 degrees (range: 78-90 degrees). The average forearm supination range of motion was 80.4 degrees (range: 75-85 degrees). All the fractures healed (a 100% healing rate), the MEPS score was 96.7 (range: 85-100), and the MEPS ratings of excellent and good were both 100%. The VAS pain scores ranged from 0-1. The minimally invasive treatment of Mason type II radial head fractures using intramedullary fixation with double elastic nails proved to be a simple approach with a relatively short operation time. It required only a small incision with little trauma and had few complications, so it is worth consideration for wider use.
桡骨头骨折(RHFs)在所有肘部骨折中最为常见。目前的治疗方法对梅森(Mason)II型桡骨头骨折存在若干局限性。本研究旨在评估一种使用双钛弹性髓内钉进行髓内固定治疗梅森II型桡骨头骨折的新型微创治疗方法的临床疗效。2018年1月至2019年12月,我们团队使用双钛弹性髓内钉对32例梅森II型桡骨头骨折进行了微创治疗。治疗后,我们进行总结并开展回顾性分析,以评估手术操作本身、骨折复位质量、骨折愈合情况及任何并发症。采用梅奥肘关节功能评分(MEPS)和视觉模拟评分(VAS)疼痛评分来评估该方法的临床疗效。所有患者术后均康复,无任何并发症。我们对所有病例平均随访了12个月。肘关节伸展活动范围为5度(范围:0 - 15度),肘关节屈曲活动范围为140度(范围:135 - 146度),前臂平均旋前活动范围为84.1度(范围:78 - 90度)。前臂平均旋后活动范围为80.4度(范围:75 - 85度)。所有骨折均愈合(愈合率100%),MEPS评分为96.7(范围:85 - 100),MEPS优良率均为100%。VAS疼痛评分范围为0 - 1分。采用双弹性髓内钉髓内固定微创治疗梅森II型桡骨头骨折是一种操作简单、手术时间相对较短的方法。只需小切口,创伤小,并发症少,值得更广泛应用。