摘要
目的探讨应用钛质弹性钉(TEN)微创治疗成人桡骨颈骨折的临床疗效。方法回顾性分析解放军海军第971医院骨科2013年8月-2018年8月收治的17例成人桡骨颈骨折患者临床资料,男性9例,女性8例;年龄19~63岁,平均37.6岁。根据Mason骨折分型,Ⅱ型14例,Ⅲ型2例,Ⅳ型1例。对于MasonⅡ型骨折,手术均采用弹性钉微创固定,必要时采用克氏针经皮撬拨、推顶复位;2例MasonⅢ型骨折采用小切口切开辅助复位、克氏针联合弹性钉固定;1例MasonⅣ型骨折采用带线锚钉修复内外侧副韧带,弹性钉固定桡骨颈部骨折。术后肘关节功能根据Metaizeau标准评定。结果17例患者获得平均22.3个月的随访,无软组织感染发生。根据Metaizeau标准,14例MasonⅡ型骨折,优11例,良3例;2例MasonⅢ型骨折,中1例,差1例;1例MasonⅣ型骨折,良1例。结论弹性钉可以用于治疗成人桡骨颈骨折,对于成人桡骨颈MasonⅡ型骨折疗效显著,对于桡骨头完整的MasonⅣ型骨折也有较好的疗效,对于桡骨头碎裂严重的MasonⅢ型骨折疗效最差。
Objective To explore the clinical effect of minimally invasive treatment of radial neck fractures in adults with titanium elastic nailing(TEN).Methods Totally 17 cases of adult radial neck fracture were treated at Department of Orthopedics,the 971 Hospital of PLA from Aug.2013 to Aug.2018.There were 9 males and 8 females with an average age of 37.6 years(range 19-63 years).According to Mason typing,14 cases were typeⅡ,2 cases were typeⅢ,and 1 case was MasonⅣ.Fractures of typeⅡreceived closed reduction and minimally invasive insertion of TEN to fix the fractures,and sometimes using Kirschner wire percutaneous reduction if necessary.Fractures of typeⅢwere fixed with TEN combined with Kirschner wire with small incision which was used to assist the reduction.Fracture of typeⅣwas fixed with TEN,and the medial and lateral collateral ligaments were repaired with suture anthers.The elbow function was assessed according to Metaizeau criteria.Results The patients were followed up for an average of 22.3 months,without soft tissue infection.According to the Metaizeau standard,11 cases were excellent,4 good,1 fair and 1 poor.In 14 cases of MasonⅡfractures,11 cases were excellent,and 3 cases were good.In 2 cases of MasonⅢfractures,1 case was moderate,and 1 case was poor.In 1 case of typeⅣ,this case was good.Conclusion ETN can be used to treat radial neck fractures in adults.The effect of minimally invasive treatment for MasonⅡfractures of the radius neck in adults with elastic nail is significant.The surgical outcome is also satisfied with Mason typeⅣfracture whose radial head is intact,and the outcome of Mason typeⅢfracture is the worst.
作者
尹海磊
孙吉霞
高旭
张伟
韩国一
李飞
YIN Hai-lei;SUN Ji-xia;GAO Xu;ZHANG Wei;HAN Guo-yi;LI Fei(Orthopaedic WardⅡ,the 971 Hospital of PLA,Qingdao,Shandong 266071,China;Hand and Foot Trauma Surgery of Qingdao Central Hospital,Qingdao,Shandong 266071,China;Qingdao University,Qingdao,Shandong 266021,China)
出处
《创伤外科杂志》
2020年第5期350-353,共4页
Journal of Traumatic Surgery
关键词
桡骨颈骨折
弹性钉
微创
成人
radial neck fracture
elastic nail
minimally invasive
adult
