Baydar Mehmet, Aykut Serkan, Mert Muhammed, Keskinbiçki M Vakif, Akdeniz H Emre, Öztürk Kahraman
. University of Health Sciences Turkey, Metin Sabancı Baltalimani Bone Diseases Teaching and Research Hospital, Department of Hand and Upper Extremity Surgery, Istanbul, Turkey.
. University of Health Sciences Turkey, Metin Sabancı Baltalimani Bone Diseases Teaching and Research Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey.
Acta Ortop Bras. 2022 Jan 28;30(1):e244357. doi: 10.1590/1413-785220223001e244357. eCollection 2022.
We evaluated the clinical and radiological outcomes of capitellar fractures treated with modified screw insertion (inserting the first fixation screw anteroposteriorly and the second screw posteroanteriorly), a technique that can be applied with a minimally invasive lateral elbow approach.
Twenty-one isolated capitellum fractures that were surgically treated were included in the study. Fixation was achieved with two headless cannulated compression screws placed in anteroposterior and posteroanterior order using the modified lateral elbow approach. The Broberg-Morrey rating system was used to assess the post-operative functional status of the patients.
According to the Broberg-Morrey criteria, the mean score was 92.7 (77-100) and 13 cases had excellent, 7 had good, and 1 had fair results. None of the patients developed avascular necrosis or heterotopic ossification. According to the Broberg-Morrey arthrosis score, two cases had Grade 1 and one had Grade 2 arthrosis. One patient had a superficial wound site infection that was treated with antibiotics, and in one case a 60° extension loss was observed in the elbow.
Treatment of isolated capitellar fractures with 2 headless screws placed anteroposteriorly and posteroanteriorly can provide stable fixation and is less traumatic for the elbow joint.
我们评估了采用改良螺钉置入法(先从前向后置入第一枚固定螺钉,再从后向前置入第二枚螺钉)治疗的肱骨小头骨折的临床和影像学结果,该技术可通过微创外侧入路应用于肘关节。
本研究纳入21例接受手术治疗的孤立性肱骨小头骨折。采用改良外侧入路,按从前向后和从后向前的顺序置入两枚无头空心加压螺钉进行固定。使用Broberg-Morrey评分系统评估患者术后的功能状态。
根据Broberg-Morrey标准,平均评分为92.7(77 - 100),其中13例结果为优,7例为良,1例为可。所有患者均未发生缺血性坏死或异位骨化。根据Broberg-Morrey关节病评分,2例为1级关节病,1例为2级关节病。1例患者出现浅表伤口部位感染,经抗生素治疗,1例患者肘关节出现60°伸展受限。
采用从前向后和从后向前置入两枚无头螺钉治疗孤立性肱骨小头骨折可提供稳定的固定,且对肘关节的创伤较小。