[1]符玉亮曹源崔增桢白梁宇吕扬**.无头加压螺钉和解剖钢板内固定治疗骨折块≤3块的桡骨头颈骨折的中长期疗效比较[J].中国微创外科杂志,2025,01(6):335-341.
　Fu Yuliang,Cao Yuan,Cui Zengzhen,et al.Mid to Longterm Outcomes of Headless Compression Screws Versus Anatomical Plate Fixation for Radial Head and Neck Fractures With ≤ 3 Fragments[J].Chinese Journal of Minimally Invasive Surgery,2025,01(6):335-341.
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无头加压螺钉和解剖钢板内固定治疗骨折块≤3块的桡骨头颈骨折的中长期疗效比较()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年6期
页码:
335-341
栏目:
临床论著
出版日期:
2025-06-25

文章信息/Info

Title:
Mid to Longterm Outcomes of Headless Compression Screws Versus Anatomical Plate Fixation for Radial Head and Neck Fractures With ≤ 3 Fragments
作者:
符玉亮曹源崔增桢白梁宇吕扬**
(北京大学第三医院骨科骨与关节精准医学教育部工程研究中心，北京100191)
Author(s):
Fu Yuliang;  Cao Yuan;  Cui Zengzhen;  et al.
Department of Orthopedics, Peking University Third Hospital；Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
关键词:
桡骨头骨折; 螺钉; 钢板; 内固定
Keywords:
Radial head fracture; Screw; Plate; Internal fixation
文献标志码:
A
摘要:
目的比较使用螺钉或钢板进行内固定治疗骨折块≤3块的桡骨头颈骨折的中长期疗效。方法回顾性分析2013年1月~2022年12月70例粉碎性桡骨头颈骨折资料，桡骨颈骨折合并桡骨头碎裂为2块44例，3块26例，其中31例无头加压螺钉内固定(螺钉组)，39例解剖钢板内固定(钢板组)。比较2组梅奥肘关节功能评分(Mayo Elbow Performance Score，MEPS)、肘关节及前臂运动范围、并发症及再手术原因。结果2组各1例因骨折不愈合(内固定失败)行桡骨头置换，其余68例均达到骨折愈合标准，随访时间20~135个月，平均66.7月，其中<36个月14例，36~60个月18例，>60个月36例。末次随访MEPS评分85~100分，中位数100分，2组差异无显著性(P=0.762)。螺钉组旋后优于钢板组(78.5°±50° vs.76.2°±4.6°，t=2.010，P=0.049)，2组屈、伸、旋前差异无显著性(P>0.05)。螺钉组总并发症发生率低［12.9%(4/31) vs. 46.2%(18/39)，P=0.003］，二次手术率低［6.5%(2/31) vs. 30.8%(12/39),P=0.012］,因硬件激惹症状引起的二次手术率低［3.3%(1/31) vs. 25.6%(10/39)，P=0.026］。结论对于骨折块≤3块的桡骨头颈骨折的内固定治疗，采用钢板及螺钉均可取得良好的长期疗效，螺钉内固定可降低术后二次手术率。
Abstract:
ObjectiveTo compare the mid to longterm clinical outcomes between screw and plate fixation for radial head and neck fractures with ≤ 3 fragments.MethodsThis retrospective study included 70 cases of comminuted radial head and neck fractures treated between January 2013 and December 2022. Fracture patterns included 44 cases with 2 fragments and 26 cases with 3 fragments. Patients were divided into screw fixation group (n=31, headless compression screws) and plate fixation group (n=39, anatomic plate). A comparison was conducted in the Mayo Elbow Performance Score (MEPS), range of motion of the elbow and forearm, complications, and reasons for reoperation.ResultsOne case in each of the two groups required radial head arthroplasty due to nonunion of the fracture (failure of internal fixation), while the remaining 68 cases met the criteria of fracture union. Followup duration ranged for 20-135 months (mean, 66.7 months). Among them, 14 cases were less than 36 months, 18 cases were between 36-60 months, and 36 cases were over 60 months. At the last followup, the MEPS score was 85-100 points, with a median of 100 points, and there was no significant difference between the two groups (P=0.762). The screw fixation group demonstrated superior supination to the plate fixation group (78.5°±5.0° vs. 76.2°±4.6°, t=2.010, P=0.049), while flexion, extension, and pronation showed comparable outcomes between the two groups (P>0.05).Compared to the plate fixation group, the screw fixation group had significantly lower overall complication rates ［12.9% (4/31) vs. 46.2% (18/39), P=0.003］, reduced reoperation rate ［6.5% (2/31) vs. 30.8% (12/39), P=0.012］ and reoperation rate due to hardware irritation ［3.3% (1/31) vs. 25.6% (10/39), P=0.026］.ConclusionsBoth fixation methods provide satisfactory outcomes for radial head and neck fractures with ≤ 3 fragments. Screw fixation demonstrates a reduced postoperative reoperation rate.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金面上项目(12474461)；北京大学第三医院创新转化基金(BYSYZHKC117)**通讯作者，Email：lvyang42@126.com
更新日期/Last Update: 2025-08-20