关节镜下与切开复位Herbert钉内固定治疗桡骨小头骨折短期疗效比较

目的 比较关节镜下与切开复位Herbert钉内固定治疗桡骨小头骨折的短期临床疗效.方法 采用回顾性病例对照研究分析2017年1月至2018年12月上海中冶医院收治的38例单侧桡骨小头骨折(Mason Ⅱ型)患者的临床资料,其中男22例,女16例;年龄20～65岁[(37.4±12.6)岁].20例采用关节镜下复位Her...

Comparison of short-term effects of arthroscopic and open reduction and internal fixation with Herbert screws in treatment of radial head fractures

Objective To compare the short-term clinical effect of arthroscopic and open reduction and intemal fixation with Herbert screws in treatment of Mason type Ⅱ radial head fractures.Methods A retrospetive case-control study was conducted to analyze the elinical data of 38 patients with umilateral radial head fractures(Mason type Ⅱ)adnmited to Shanghai Zhongye Hospial from January 2017 to December 2018。including 22 males and 16 females,aged from 20 to 65 years[(37.4±12.6)years].Twenty patients were teated by arthnoscopie reduction and intenal fixation with Hebert screw(Group A),and eighteen by open reduction and internal fixation with Herbert screw(Goup B).The operation time and fracture hbealing time were recorded.The visual analogue scale(VAS).elbow lexion and exlension range,forearn rotation range and Mayo ebow function score were compared between the two groups before and at 1,3,6,and 12 months ater operation.The results of Mayo elbow perfornance score(MEPS)and upper limb function ssssent using the disabilites of the arm,shoulder,and hand(DASH)soore were compared between the lwo groups.Complications including screw breakage or fracture displacenent were also evaluated.Results All patients were fllowed up for 12-14 mnonhs[(12.3±2.3)months].There was no significant dfference in operation time betwen the two groups(P>0.05).The fracture healing time was(8.9±0.6)weeks in Group A and(8.7±0.6)weeks in Group B(P>0.05).There was no signifcant dilrence in VAS between the two groups before operation(P>0.05).The VAS was(4.8±0.5)points at 1 month after opention in Group A,lower than(6.0±0.7)points in Group B(P<0.05).There was no significant dilrence in VAS between Group A and Group B at 3,6,and 12 muhs after openation(P>0.05).Thene was mo significant diference in elbow flexion and extension range between the two groups before operation(P>0.05).The elbow flexion and extension range in Group A was(110.413.8)°and(137.1±4.0)°at 1,3 months ater operation,which was signifcant greater than(90.6±4.7)°and(125.113.5)°in Group B(P<0.05).There was no signifcant dfference in elbow flexion and extension range between the two groups al 6 and 12 monhs after operation(P>005).There was no signifcant dfference in the range of foream rotation between the two groups before operation(P>0.05).The range of forearm rotation in Group A was(107.1±2.8)°and(138.1±2.9)°at 1,3 months afer operation,sigifianly greater than(95.5±3.9)°,(121.5±3.0)°in Group B(P<0.05).There was no significant diference in forearm rotation range between the two groups all 6 and 12 months after surgery(P>0.05).There was no significant diference in MEPS between the two groups before operation(P>0.05).The MEPS in Group A was(50.4±3.8)prints at 1 month ater operation,higher than(40.6±4.7)points in Group B(P<005).There was n signifcant dilrence in MEPS between the two groups 3,6,and 12 months after operation(P>0.05).There was no signifeant difrence in DASH score between the two groups before operation(P>0.05).The DASH score was(57.1±2.8)pints at 1 month afer surgery in Group A,higher than(42.5±3.9)points in Group B(P<0.05).The DASH sore was not signifeantly diferent between the lwo groupe at 3,6,and 12 mouths after operation(P>0.05).There was no surew losening or fracture afer operation,and one patient in each group had fracture displacement(P>0.05).Conclusion For Mason type Ⅱ nedial head fractures。arthroscopic Herbert screw fixation has the advantages of less trauna,les pain and faster functional recovery of the afced limb compared with open reduction and Herbert secrew fixation.