目的:观察随访用Herbert螺钉内固定治疗Mason Ⅱ、Ⅲ型桡骨小头骨折的临床近期疗效.方法:2008年3月至2010年7月,采用切开复位Herbert螺钉内固定治疗15例Mason Ⅱ、Ⅲ型桡骨小头骨折,男6例,女9例;年龄18～55岁,平均32岁;左侧7例,右侧8例.受伤到入院时间3～10 h.患者入院时肘部肿胀疼痛,肘关节活动受限,肘关节可闻骨擦音,X线片示桡骨小头骨折.对患者术后肘关节功能恢复观察采用Mayo肘部评分系统.结果:术后患者伤口愈合Ⅰ/甲,术后未见肘关节骨化性肌炎,随访6～15个月,依据Mayo肘部评分,优8例,良5例,可2例.Mayo评分(86.67±1.26 )分,其中疼痛(53.33±9.76)分,关节活动度(27.33±4.58)分,关节稳定性(6.00±2.07)分;肘关节活动度70°～130°,平均(105±10)°,前臂旋转度100°～130°,平均(120±16)°.结论:用Herbert螺钉对Mason Ⅱ型及部分Mason Ⅲ型桡骨小头骨折固定,复位满意、固定可靠、方法简单,利于早期进行功能锻炼.%Objective: To observe the short-term therapeutic effects of Herbert screw fixation on type Mason II , HI radial head fractures. Methods:From March 2008 to July 2010,15 patients with Mason II , HI radial head fractures were treated by open reduction and Herbert screw fixation including 6 males and 9 females with the mean age of 32 years (from 18 to 55). Seven cases were left and 8 cases were right. The interval from injury to hospitalization ranged from 3 to 10 hours. The clinical symptoms were swelling, pain, restricted movement in elbow. Bonycrepitus were heard on the elbow joint and X-ray film showed radial head fractures. Mayo elbow scoring system was used to evaluate recovery of elbow function. Results: All the incisions primarily healed without myositis ossificans. All the patients were followed up for 6 to 15 months. According to Mayo elbow score,the result was excellent in 8 cases,good in 5 cases and fair in 2 cases. Mayo score was (86.67±1.26) points,which including pain(53.33±9.76) .joint function(27.33±4.58 ) ,joint stability(6.00±2.07); elbow joint mobility was 70°-130° with the average of( 105±10)° .forearm rotation was 100°-130° with the average of (120±16)°. Conclusion:Treatment of Mason II , ffl radial head fractures with Herbert screw fixation has advantages of satisfactory reduction, reliable fixation, easy operating and early movement of joint.
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