摘要
目的探讨及分析人工桡骨头置换治疗桡骨头粉碎性骨折术后肘外翻及其他并发症的产生因素。方法自2008年8月至2014年10月，我们采用人工桡骨头置换治疗桡骨头粉碎性骨折患者21例，其中合并肱骨远端粉碎性骨折1例，合并尺骨鹰嘴骨折5例，合并肘关节脱位6例。按Mason分型，Ⅲ型15例，Ⅳ型6例。结果术后19例患者获得随访，2例失访，时间为5～79个月，平均39．9个月。按Mayo肘关节功能评定标准评定：优16例，良2例，可1例。术后肘关节携带角，患侧肘外翻角度大于健侧10。以上的患者为4例。7例出现不同程度的桡骨柄周围射线可透过区。未见切口感染、神经损伤、金属异物反应及腕部畸形等并发症。1例出现肘关节僵硬再次行关节松解术。5例肘部有轻度异位骨化，但未对肘和前臂运动造成明显影响。结论人工桡骨头置换治疗桡骨头粉碎性骨折可获得比较满意的中期疗效。术后常见并发症为肘外翻及假体松动等，这可能与手术操作技巧、假体填充及假体强度等因素相关。
Objective To analyze the predisposition factors for cubitus valgns and other complications following radial head prosthesis replacement in treating comminuted fractures of the radial head. Methods From August 2008 to November 2011, 21 cases of radial head comminuted fractures were treated with prosthetic radial head replacement. There was one ease with combined distal humeral fracture, 5 cases with combined oleeranon fractures and 6 cases with combined elbow dislocation. Based on Mason classification, there were 15 type Ⅲ fractures and 6 type Ⅳ fractures. All were closed injuries that were surgically treated 2 weeks after the injury. Results Postoperatively 19 cases were follow-up while two cases were reportedly lost for follow-up. The follow-up period ranged from 5 to 79 months （mean 39.9 months）. According to the Mayo elbow performance scoring system, the results were assessed as excellent in 16 cases, good in 2 cases and fair in 1 case. Out of the 19 cases, 4 cases had an elbow carrying angle more than 10° greater than that of the contralateral side. Seven cases had varying degrees of radiolucent area around the radius stem. There was no wound infection, nerve damage, metallic foreign body reaction, or wrist deformities. Elbow stiffness occurred in one case that required arthrolysis. There were 5 cases that had mild heterotopic ossification in the elbow, which did not significantly impair the movement of the elbow and forearm. Conclusion Prosthetic radial head replacement for treatment of radial head fractures lead to satisfactory intermediate term results. The most common complications are cubitus valgns and loosening of the prosthesis which may be attributed to surgical skills, the lack of filler or prosthesis strength.
出处
《中华手外科杂志》
CSCD
北大核心
2016年第6期439-442,共4页
Chinese Journal of Hand Surgery
关键词
桡骨
骨折
桡骨头置换
并发症
Radius
Fractures,bone
Radial head replacement
Complications
作者简介
通信作者：郑强，Email：zhq1967@hotmail．com
