切开复位微型钢板螺钉内固定治疗成人桡骨小头骨折的临床研究

目的探讨切开复位微型钢板螺钉内固定治疗成人桡骨小头骨折的临床疗效。方法选取本院2009年12月～2012年1月收治的成人桡骨小头骨折患者31例,均给予切开复位微型钢板螺钉内固定治疗,术后随访10～17个月,平均随访（12.4±3.5）个月,分析患者术后的临床指征、临床疗效、并发症情况。结果患者的术后骨折骨性愈合时间为2.1～3.5个月,平均愈合时间为（2.7±0.4）个月,住院时间为24～67d,平均住院时间为（39.2±10.6）d。23例（74.2%）患者的术后肘关节功能为优,7例（22.6%）患者的术后肘关节功能为良,1例（3.2%）患者的术后肘关节功能为可,总体优良率为96.8%。患者术后VAS疼痛评分[（4.0±0.5）分]明显低于术前VAS疼痛评分[（8.1±0.7）分],差异有统计学意义（P〈0.05）。1例患者发生腕关节炎,1例患者发生肘关节异位骨化,未见桡神经损伤、早期桡骨头坏死、内固定松动等并发症,并发症发生率为6.5%。结论切开复位微型钢板螺钉内固定是治疗成人桡骨小头骨折的有效方法,可明显改善患者的临床病症,提高治愈率,固定牢靠且并发症少,值得临床推广使用。

Clinical research of open reduction mini plate screw internal fixation in treatment for adult radial head fracture

Objective To investigate the clinical effect of open reduction mini plate screw internal fixation in treatment for adult radial head fracture. Methods Thrity-one patients with adult radial head fracture were selected in our hospi- tal from December 2009 to January 2011, who were given treatment of open reduction mini plate screw internal fixa- tion. Patients were followed up for 10-17 months, while average time was （12.4±3.5） months. Postoperative clinical in- dications, clinical efficacy, complications of patients were analyzed. Results Postoperative fracture healing time were 2.1-3.5 months, while average healing time was （2.7±0.4） months. Hospitalization time was 24-67 d, while average hos- pitalization time was （39.2±10.6） d. Postoperative elbow joint function was excellent in 23 patients （74.2%）. Postopera rive elbow joint function was good in 7 patients （22.6%）. Postoperative elbow joint function was sure in 1 patient （3.2%）. Overall effective rate was 96.8%. Postoperative VAS pain score [（4.0±0.5） points] was significantly lower than preoper- ative score VAS pain score [（8.1±0.7） points], while difference was statistically significant （P 〈 0.05）. 1 patient was wrist arthritis. 1 patient was elbow heterotopic ossification. There were no radial nerve injury, early radial head necro- sis, internal fixation loosening and other complications. Complication rate was 6.5%. Conclusion Open reduction mini plate screw internal fixation is effective treatment method for adult radial head fracture,which can obviously improve clinical condition and improve cure rate. Fixation is finn, while complication is less. That is worthy of clinical use.