人工桡骨头置换术治疗桡骨头粉碎性骨折

目的 :探讨人工桡骨头假体置换术治疗桡骨头粉碎性骨折的近期疗效。方法:自2011年6月至2015年6月,采用人工桡骨头置换术治疗桡骨头粉碎性骨折25例,男10例,女15例;年龄24~61岁,平均40岁。分析不同时期患者患肢肘关节功能恢复情况,与健侧比较肘关节的活动度情况及末次随访时患侧肘关节功能评价情况。结果:25例均获随访,时间12~48个月,平均26个月,无感染、肘关节不稳定、下尺桡关节半脱位、骨化性肌炎等并发症发生。术后6、9个月及末次随访患者的VAS疼痛评分、Broberg和Morrey肘关节功能评分与术后3个月比较均改善(P0.05)。肘关节的屈伸活动度、旋转活动度在术后3、6、9个月与健侧差异有统计学意义(P0.01),但末次随访时与健侧比较差异无统计学意义(P0.05)。末次随访时根据Broberg和Morrey肘关节功能评分标准,优16例,良7例,可2例。结论 :人工桡骨头置换术治疗无法修复的桡骨头粉碎性骨折,能最大程度恢复肘关节的稳定性,早期进行功能锻炼,预防和减少并发症的发生,近期疗效满意,远期疗效待进一步观察。

Artificial radial head replacement for the treatment of comminuted fractures of the radial head

Objective: To assess the clinical effects of artificial radial head prosthesis replacement for the treatment of comminuted fracture of the radial head.Methods: From June 2011 to June 2015,25 patients with radial head comminuted fracture were treated with artificial radial head replacement,including 10 males and 15 females,ranging in age form 24 to 61 years old(mean,40 years old). The functional recovery of the patients suffering from limb and elbow in different periods,the activity degree of the elbow joint and the function of the elbow in the latest follow-up were compared.Results: All the patients were followed up,and the duration ranged from 12 to 48 months,averaged 26 months. There were no complications such as infection,elbow instability,subluxation of the distal radioulnar joint,and myositis ossificans. The VAS,Broberg and Morrey elbow function score were improved 6,9 months after operation compared with that 3 months after operation(P<0.05). There were significant differences in elbow flexion and extension,rotation activity between injured side and healthy side 3,6,9 months after operation(P<0.01),but no significant differences between injured side and healthy side at the latest follow-up(P>0.05). At the latest follow-up,according to Broberg and Morrey elbow function evaluation criteria,16 cases got an excellent result,7 good and 2 poor.Conclusion: It can maximize the recovery of elbow joint stability and quicken early functional exercise,prevent and reduce the occurrence of complications by using the artificial radial head replacement therapy to repair comminuted fracture of the radial head. The short-term curative effect is satisfactory,but the long-term effect needs further observation.