克氏针与微型钢板治疗MasonⅡ型及Ⅲ型桡骨头骨折的病例对照研究

目的:比较克氏针与微型钢板治疗MasonⅡ、Ⅲ型桡骨头骨折疗效。方法:2004年5月至2010年3月收治MasonⅡ、Ⅲ型桡骨头骨折共50例,其中使用克氏针治疗23例,微型钢板治疗27例。克氏针治疗组中男13例,女10例;平均年龄(42.5±0.7)岁;MasonⅡ型骨折14例,Ⅲ型骨折9例。微型钢板组中男17例,女10例;平均年龄(41.7±0.5)岁;MasonⅡ型骨折16例,Ⅲ型骨折11例。按照Broberg和Morrey的肘关节功能评分标准进行评分,比较两组患者异位骨化情况及临床疗效。结果:所有患者获随访,时间12～24个月,平均(16.5±1.3)个月,根据疗效评定标准,微型钢板组平均(90.5±11.6)分,克氏针组平均(70.6±11.3)分。微型钢板组优15例,良9例,一般2例,差1例;克氏针组优8例,良9例,一般3例,差3例。微型钢板组疗效优于克氏针组。而两组患者异位骨化发生率比较差异无统计学意义。结论:微型钢板治疗桡骨头骨折安全有效,疗效优于克氏针。

Comparison between open reduction internal fixation with kirschner nails and mini-plates in treatment of Mason type II and III fractures of radial head: a case-control study

Objective:To compare the effect between open reduction internal fixation with Kirschner nails and mini-plates in the treatment of Mason type Ⅱ and III fractures of radial head.Methods:From May 2004 to March 2010,50 cases of Mason type Ⅱ and III fractures of radial head were treated with Kirschner nails or mini-plates.In Kirschner nail group,there were 13 males and 10 females(mean age 42.5±0.7 years),and 14 cases of Mason type Ⅱ and 9 cases of Mason type Ⅲ fracture.In mini-plate group,there were 17 males and 10 females(mean age 41.7±0.5 years),and 16 cases of Mason type Ⅱ and 11 cases of Mason type of Ⅲ fracture.The excellent and good rates according to the Broberg and Morrey Elbow Score,and the rate of ectopic ossification were compared.Results:All the patients were followed up for 12-24(mean 16.5±1.3) months.The Broberg and Morrey Elbow Score of mini-plate group was(90.5±11.6),and that of Kirschner nail group was(70.6±11.3).The result of mini-plate group was excellent in 15 cases,good in 9 cases,fair in 2 cases,and poor in 1 case;The result of Kirschner nail group was excellent in 8 cases,good in 9 cases,fair in 3 cases and poor in 3 cases.The effect of mini-plate group was better than that of Kirschner nail group.There was no statistic difference in the rate of ectopic ossification between the two groups(P>0.05).Conclusion:Fractures of radial head can be well treated with open reduction and internal fixation by mini-plates,which offer better results than Kirschner nails.