MasonⅠ、Ⅱ型桡骨小头骨折非手术治疗的比较研究

目的评价并比较对MasonⅠ、Ⅱ型桡骨小头骨折应用功能治疗方法(早期肘关节活动)与传统石膏固定方法的治疗效果,以及对肘关节功能的影响。方法对67例MasonⅠ、Ⅱ型桡骨小头骨折随机分成两组;石膏固定组:长臂石膏固定4周后拆除,开始功能锻炼。功能治疗组:骨折后不用外固定或短期内应用(固定时间3～10d),早期进行关节活动。按照Broberg和Morrey的评定标准对两组肘关节进行功能评分[1]。结果全部病例获得随访,其中石膏组33例,功能治疗组34例;随访时间12～36个月,平均20个月。肘关节功能评分:石膏固定组平均为90.8分,极好14例,好14例,一般5例,优良率达84.8%。功能治疗组平均为96.5分,极好22例,好12例,优良率达100%;功能治疗组明显优于石膏固定组(P<0.01)。结论早期肘关节活动可显著提高MasonⅠ、Ⅱ型桡骨小头骨折后肘关节的功能。

Mason type I and type II radial head fractures: a comparison of two conservative treatment methods

Objective To evaluate and compare the short term results of two conservative treatment methods for Mason type I and type II radial head fractures: functional therapy and conventional plaster immobilization. Methods 67 cases of Mason type I and type II radial head fractures were randomly divided into two groups. Patients of plaster immobilization group were treated with 4 weeks of long arm cast immobilization followed by rehabilitation, while patients of functional therapy group all began early elbow motion without immobilization or with brief immobilization only for 3 to 10 days. Elbow function was assessed adopting Broberg and Morrey elbow score. Results 67 cases (33 for the immobilization group and 34 for early motion group) were followed, the mean follow-up period being 20 months (12-36months). The average elbow score was 90.8 for immobilization group and 96.5 for early motion group. 14 cases were graded excellent, 14 good, and 5 fair in the immobilization group. The overall excellent and good rate was 84.8%. In early motion group, there were 22 cases of excellent,12 cases of good and no case of fair and unacceptable results. The percentage of excellent and good results was 100%. The arc of the motion and functional score of the early motion group were significantly better than that of the immobilization group. Conclusion Functional treatment for Mason type I and type II radial head fractures can remarkably improve elbow function, especially for the arc of elbow motion.