Clinical Results of Surgical Treatment for Comminuted Radial Head and Neck Fracture: Headless Compression Screws Versus Plate Fixation
Clinical Results of Surgical Treatment for Comminuted Radial Head and Neck Fracture: Headless Compression Screws Versus Plate Fixation
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DOI：
10.1007/s43465-022-00792-4
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发表时间：
2022-12-13
影响因子：
1
通讯作者：
Matsuura, Takeshi
中科院分区：
文献类型：
--
作者：
Yano, Koichi;Fukuda, Makoto;Matsuura, Takeshi
背景：我们采用无头加压螺钉手术治疗粉碎性桡骨头和桡骨颈骨折，包括桡骨头多枚螺钉和桡骨颈单枚斜向螺钉。本研究旨在比较使用无头加压螺钉和单枚斜向螺钉治疗桡骨颈粉碎性骨折的临床和影像学结果，我们的新手术，以及桡骨近端预塑形的接骨板系统。方法回顾性分析23例患者，螺钉组11例，钢板组12例。根据Broberg和Morrey改良的Mason-Johnston分类，骨折为3型。分析的临床结局包括手肘和前臂的活动范围、马约肘关节功能评分和放射学评估。此外，还研究了术后并发症。平均随访18个月。结果所有患者均获得骨性愈合，除前臂旋后外，临床结局和影像学评估无显著差异（p = 0.02）。此外，螺钉组和钢板组分别有1名和5名患者接受了额外的外科手术（p = 0.16）。钢板组有2例患者出现后神经麻痹。螺钉组和钢板组分别有1例和6例患者出现并发症（p = 0.07）。结论两种术式均获得了良好的临床和影像学效果，骨和韧带损伤均得到修复。螺钉组的前臂旋后范围大于钢板组。
Background We surgically treated comminuted radial head and neck fractures using headless compression screws, including multiple screws for the radial head and a single oblique screw for the radial neck. This study aimed to compare the clinical and radiological results for comminuted radial head and neck fractures between surgery using headless compression screws with a single oblique screw for the radial neck, our new procedure, and a plate system precontoured to the proximal radius. Methods This retrospective study included 23 patients (11 and 12 in the screw and plate groups, respectively). The fractures were type 3 according to the Mason-Johnston classification modified by Broberg and Morrey. Clinical outcomes analyzed included the motion range of the elbow and forearm, Mayo Elbow Performance Score, and radiological assessments. In addition, postoperative complications were also investigated. The average follow-up was 18 months. Results The bone union was achieved in all the patients, and there were no significant differences in clinical outcomes and radiological assessments except forearm supination (p = 0.02). Furthermore, additional surgical procedures were performed in one and five patients in the screw and plate groups, respectively (p = 0.16). Posterior nerve palsy was observed in two patients in the plate group. Complications were observed in one and six patients in the screw and plate groups, respectively (p = 0.07). Conclusion Both surgical procedures achieved good clinical and radiological outcomes with bone and ligament injury repair. The screw group had a greater range of forearm supination than the plate group.