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掌骨预弯钢板治疗桡骨头骨折的疗效。

Outcomes of radial head fractures treated with pre-curved metacarpal plate.

机构信息

Department of orthopedics, General Hospital of Central Theater Command, Wuhan, Hubei Province, P. R. China.

Wuhan University of Science and Technology, Wuhan, Hubei Province, P. R. China.

出版信息

BMC Musculoskelet Disord. 2023 May 30;24(1):437. doi: 10.1186/s12891-023-06566-9.

Abstract

OBJECTIVE

To explore the clinical outcomes of MasonII/III radial head fractures without the neck involvement treated with pre-curved metacarpal plates.

METHODS

Ninety cases of Mason typeII/III radial head fractures without the neck involvement were retrospectively collected from the department of orthopaedics of our hospital from September 2015 to May 2021. Group A (n = 44) underwent open reduction and internal fixation with pre-curved metacarpal plate, and Group B (n = 46) were fixed by traditional T-shaped plates. The operation time and the incision length were recorded during the operation. The Mayo Elbow Performance Score (MEPS), Disability of Arm, Shoulder and Hand (DASH) score, visual analogue scale (VAS) for pain, range of motion (ROM) and post-operative complications were evaluated at the last follow-up.

RESULTS

All the patients were followed up for at least 12 months. There were no significant difference between two groups regarding operation time (54.2 ± 12.1 v.s 51.3 ± 7.2, mins), MEPS (88.9 ± 4.2 v.s 87.8 ± 4.4), DASH score (7.3 ± 4.6 v.s 9.0 ± 4.0), VAS (1.6 ± 0.8 v.s 1.7 ± 0.7), and ROM. However, the incision length was shorter in Group A (5.6 ± 0.5 v.s 6.6 ± 0.5, cm, P < 0.01). The postoperative complication rate was also lower in Group A (1/44 v.s 8/46, P = 0.02).

CONCLUSION

Masson II/III radial head fractures without the neck involvement treated with pre-curved metacarpal plates could achieve satisfactory outcomes comparable to traditional T-shaped plates. Moreover, the invasiveness and postoperative complications are less in patients with pre-curved metacarpal plates.

LEVEL OF EVIDENCE

III, retrospective comparison study.

摘要

目的

探讨不涉及桡骨颈的 Mason II/III 型桡骨头骨折采用预弯掌骨钢板治疗的临床疗效。

方法

回顾性收集 2015 年 9 月至 2021 年 5 月我院骨科收治的 90 例不涉及桡骨颈的 Mason II/III 型桡骨头骨折患者,其中 A 组(n=44)采用预弯掌骨钢板切开复位内固定,B 组(n=46)采用传统 T 形钢板固定。记录手术时间和切口长度。末次随访时采用 Mayo 肘关节功能评分(MEPS)、上肢功能障碍评分(DASH)、视觉模拟评分(VAS)评估疼痛、关节活动度(ROM),并记录术后并发症。

结果

所有患者均获得至少 12 个月随访。两组患者手术时间[(54.2±12.1)min 比(51.3±7.2)min]、MEPS(88.9±4.2 分比 87.8±4.4 分)、DASH 评分(7.3±4.6 分比 9.0±4.0 分)、VAS(1.6±0.8 分比 1.7±0.7 分)、ROM 比较差异均无统计学意义,A 组切口长度更短[(5.6±0.5)cm 比(6.6±0.5)cm],差异有统计学意义(P<0.01)。A 组术后并发症发生率也更低(1/44 比 8/46),差异有统计学意义(P=0.02)。

结论

不涉及桡骨颈的 Mason II/III 型桡骨头骨折采用预弯掌骨钢板治疗可获得与传统 T 形钢板相当的满意疗效,且预弯掌骨钢板的创伤更小,术后并发症更少。

证据水平

III 级,回顾性比较研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f128/10228044/063740026554/12891_2023_6566_Fig1_HTML.jpg

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