桡骨小头粉碎性骨折两种手术方法的疗效分析.docx

桡骨小头粉碎性骨折两种手术方法的疗效分析【摘要】目的比较研究桡骨小头切除术与桡骨小头置换术治疗MasonⅢ、Ⅳ型桡骨小头粉碎性骨折的临床疗效。方法1997年1月至XX年5月,共收治2例MasonⅢ、Ⅳ型桡骨小头粉碎性骨折,1例行桡骨小头切除术,1例行桡骨小头置换术。对两组患者的肘、腕关节的疼痛、运动、肌力、X线表现以及肘关节功能评分进行了比较研究。结果两组分别平均随访年和2年,切除组平均肘关节痛觉及视觉模拟(VAS)评分为分,置换组为分(P<);切除组肘关节伸直角度平均-°,置换组平均-°(P<);切除组肘关节屈曲度、前臂旋转活动度与置换组差异无显著性差异(P>),但两组的伸肘、旋前以及旋后肌力减弱差异有显著性差异(P<);切除组提携角平均增大°、桡骨移位mm,置换组分别为°和,差异有显著性差异(P<);切除组Broderg和Morrey肘关节功能评分平均为分,置换组为分(P<)。结论与桡骨小头切除术相比,桡骨小头置换术治疗MasonⅢ、Ⅳ型桡骨小头粉碎性骨折可获得较满意的关节活动范围、得到较大的肌力恢复以及良好的关节功能恢复。【关键词】桡骨小头;骨折;假体;置换;parisonbetweenTwoOperationsinClinicalTreatmentoftheFracturesofRadialHeadAbstract:paretheclinicalresultsofradialheadresectionwiththoseofradialprothesisreplacementandinternalfixationintreatmentofMasontypeⅢⅣcomminutadfractureofradialcaseofMasontypeⅢⅣradialheadfractureweretreatedinourdepartmentfromJanuary199tohadresectionofthefracturedradialhead,,motion,strength,radiographicfindings,andelbowfunctionalratingTheresectiongrouphadamainfollowup,whiletheradialprothesisreplacementgrouphadaveragepainVAS(visualanalogscale)scorewastheresectiongroupthereplacementelbowextensionaveraged-°intheresectiongroupand-°inthereplacementgroup(P<).Theelbowflexionandtheforearmrotationrangeshowednostatisticaldifferencebetweenthegroups(P>),butthedecreaseofelbowextensionandforearmrotationdifferedstatisticallybetweenthegroups(P<).Intheresectiongroup