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一项评估采用桡骨头假体治疗的梅森III型和IV型桡骨头骨折功能预后的研究。

A Study Evaluating the Functional Outcomes of Mason Type III and IV Radial Head Fractures Treated With a Radial Head Prosthesis.

作者信息

Deshmukh Ashwin, Agrawal Rahul, Solunke Swaroop, Nair Abhishek, Barosani Ankit

机构信息

Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Aug 14;16(8):e66898. doi: 10.7759/cureus.66898. eCollection 2024 Aug.

Abstract

Objective This research aimed to assess the functional result of type III and IV radial head fractures that were treated using a radial head prosthesis. Methods A retrospective investigation was conducted on 70 patients with type III and IV radial head and neck fractures, as classified by Mason. The patients were hospitalized and received treatment at the Orthopaedics Department, where they had radial head prosthesis surgery for three years. Results Among the total of 70 cases, 42 (60%) cases were below the age of 40, while 28 (47%) cases were over 40 years. The average age was 36.4 years. The maximum age recorded was 54 years, while the lowest age recorded was 30 years. The female population outnumbered the male population. The majority of instances (42, 60%) were attributed to falls, while the remaining cases were caused by road traffic accidents (RTAs). Out of the total 70 instances, 52 cases (74.28%) exhibited right-side dominance, whereas 18 cases (25.72%) exhibited left-side dominance. Within our case study group, 56 (80%) cases fell under modified Mason's classification type Ill, totaling 56 instances. The remaining 20% of the cases, amounting to 11 cases, were classified as modified Mason's classification type IV. Among the 70 patients, 55 cases (78.58%) did not have any ligamentous damage, whereas seven (10%) cases had lateral ulnar collateral ligament (LUCL) injury and eight (11%) cases had medial collateral ligament (MCL) injury. The P value for flexion, extension, pronation, and supination was shown to be very significant. Out of the total, 47 (67%) instances had an MEPI score (Mayo Elbow Performance Index) of more than 90, indicating exceptional performance. In addition, 16 cases (22.85%) had an MEPI score ranging from 75 to 89, which is considered a good result. Lastly, seven cases (10%) had an MEPI score ranging from 60 to 74, indicating a fair result. Conclusion The use of a radial head prosthesis is considered a viable option for managing severe and irreparable fractures of the radial head. Effective outcomes hinge on meticulous preoperative planning, skilled intraoperative techniques, and intensive postoperative rehabilitation. These elements collectively contribute to achieving consistent and favorable results in patients undergoing this surgical intervention.

摘要

目的 本研究旨在评估使用桡骨头假体治疗的Ⅲ型和Ⅳ型桡骨头骨折的功能结果。方法 对70例按照梅森(Mason)分类法分类的Ⅲ型和Ⅳ型桡骨头及颈部骨折患者进行回顾性调查。这些患者在骨科住院并接受治疗,他们接受桡骨头假体手术已达三年。结果 在总共70例病例中,42例(60%)年龄在40岁以下,而28例(40%)年龄超过40岁。平均年龄为36.4岁。记录到的最大年龄为54岁,最小年龄为30岁。女性人数多于男性。大多数病例(42例,60%)归因于跌倒,其余病例由道路交通事故(RTA)引起。在总共70例病例中,52例(74.28%)表现为右侧优势,而18例(25.72%)表现为左侧优势。在我们的病例研究组中,56例(80%)属于改良梅森分类Ⅲ型,共计56例。其余20%的病例,即11例,被分类为改良梅森分类Ⅳ型。在70例患者中,55例(78.58%)没有任何韧带损伤,而7例(10%)有尺侧副韧带(LUCL)损伤,8例(11%)有内侧副韧带(MCL)损伤。屈伸、旋前和旋后的P值显示非常显著。总共47例(67%)的梅奥肘关节功能指数(MEPI)得分超过90,表明表现优异。此外,16例(22.85%)的MEPI得分在75至89之间,这被认为是一个良好的结果。最后,7例(10%)的MEPI得分在60至74之间,表明结果尚可。结论 使用桡骨头假体被认为是治疗严重且无法修复的桡骨头骨折的可行选择。有效的结果取决于精心的术前规划、熟练的术中技术和强化的术后康复。这些因素共同有助于在接受这种手术干预的患者中取得一致且良好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4e7/11399111/ffd16405d809/cureus-0016-00000066898-i01.jpg

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