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92例桡骨头骨折的术后功能结局:一项基于患者报告结局量表的回顾性研究

Functional Postoperative Outcome for 92 Cases of Radial Head Fractures: A PROM-Based Retrospective Study.

作者信息

Müller Michael, Mann Verena, Zapf Julian, Kirchhoff Konstantin, Zyskowski Michael, Biberthaler Peter, Kirchhoff Chlodwig, Wurm Markus

机构信息

Department of Trauma Surgery, Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.

出版信息

J Clin Med. 2023 Sep 9;12(18):5870. doi: 10.3390/jcm12185870.

Abstract

: Fractures of the radial head are common injuries, whereas, in the case of displaced fractures, surgical treatment using screw or plate osteosynthesis, excision, or replacement of the radial head is required. However, data about patient-related outcomes (PROM) for different types of radial head fractures is limited in the current literature. Therefore, this study was conducted to evaluate the functional outcome after operatively treated radial head fractures and to further correlate these results with the initial modified Mason classification. : In this retrospective study, all suitable patients with surgical treatment of a radial head fracture were identified. Only patients with Mason II-IV fractures were included. All patients completed the Elbow Self-Assessment Score (ESAS) questionnaire. Data on fracture classification, type of surgery, and revision operations (if needed) were assessed. : A total of 92 patients suffering from fractures of the radial head (57 Mason II, 35 Mason III-fractures) who were operatively treated at our institution were enrolled. There were 42 (47.7%) female and 50 (54.3%) male patients with an average age of 47.5 ± 14.1 years. Screw osteosynthesis was performed in 67 patients, plate osteosynthesis in 20 patients, and five patients received radial head arthroplasty. The average ESAS score accounted for 89.7 ± 16.7. Mason II fractures showed significantly better functional results with higher ESAS scores (92.3 ± 13.9 vs. 85.4 ± 20.1) as well as significantly lower rates of necessary implant removal (0 vs. 5 (14.3%) than Mason III fractures. Screw osteosynthesis showed significantly better functional ESAS scores, 91.0 ± 16.5, than plate osteosynthesis, with 85.3 ± 17.6 ( = 0.041), but was predominantly used in Mason II fractures. : Surgical treatment using screw- and plate osteosynthesis of radial head fractures provides a good overall outcome. The postoperative function is associated with the initial Mason classification as the patients' reported outcome was worse in Mason III fractures compared to Mason type II fractures. In this context, the ESAS score can be considered a useful tool for the assessment of the patient-based functional outcome.

摘要

桡骨头骨折是常见的损伤,而对于移位骨折,需要采用螺钉或钢板内固定、切除或置换桡骨头的手术治疗。然而,目前文献中关于不同类型桡骨头骨折的患者相关结局(PROM)的数据有限。因此,本研究旨在评估手术治疗桡骨头骨折后的功能结局,并进一步将这些结果与最初的改良梅森分类法相关联。

在这项回顾性研究中,确定了所有接受桡骨头骨折手术治疗的合适患者。仅纳入梅森II-IV型骨折的患者。所有患者均完成了肘部自我评估评分(ESAS)问卷。评估了骨折分类、手术类型和翻修手术(如有需要)的数据。

共有92例在我院接受手术治疗的桡骨头骨折患者入组(57例梅森II型,35例梅森III型骨折)。有42例(47.7%)女性和50例(54.3%)男性患者,平均年龄为47.5±14.1岁。67例患者采用螺钉内固定,20例患者采用钢板内固定,5例患者接受桡骨头置换术。ESAS平均评分为89.7±16.7。梅森II型骨折的功能结果明显更好,ESAS评分更高(92.3±13.9对85.4±20.1),并且与梅森III型骨折相比,必要的植入物取出率明显更低(0对5例(14.3%))。螺钉内固定的功能ESAS评分明显优于钢板内固定,分别为91.0±16.5和85.3±17.6(P = 0.041),但主要用于梅森II型骨折。

采用螺钉和钢板内固定治疗桡骨头骨折的手术治疗总体效果良好。术后功能与最初的梅森分类相关,因为与梅森II型骨折相比,梅森III型骨折患者报告的结局更差。在这种情况下,ESAS评分可被视为评估基于患者的功能结局的有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c3c/10532215/3b7b60da5527/jcm-12-05870-g001.jpg

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