总之,桡骨头骨折的治疗应根据骨折类型,肘关节骨性和软组织稳定结构的完整与否,选择具体的手术方式,并争取术后进行早期的功能锻炼。一般讲,Mason分型Ⅰ型和Ⅱ型骨折,首选螺钉固定,肘关节稳定结构完整的Ⅲ型骨折可选择桡骨头切除,合并尺侧副韧带损伤,或尺骨茎突骨折的Ⅲ型或Ⅳ型患者则应尽量采用桡骨头置换术,并争取修复这些损伤的稳定结构。
[1]张力丹,蒋协远,王满宜,等.桡骨头骨折的手术内固定治疗[J].中华创伤骨科杂志,2002,4:227-231.
[2]蒋协远,张力丹,公茂琪,等.人工桡骨头置换治疗桡骨头粉碎骨折合并肘关节不稳定[J].中华骨科杂志,2005,25:467-471.
[3]BainGI,AshwoodN,BairdR,etal.ManagementofMasontype-IIIradialheadfractureswithatitaniumprosthesis,ligamentrepair,andearlymobilization.Surgicaltechnique[J].BoneJointSurgAm,2005,87Suppl1:136-147.
[4]BrobergMA,MorreyBF.Resultsofdelayedexcisionoftheradialheadafterfracture[J].BoneJointSurg,1986,68:669-674.
[5]梅国华,张长青,罗从风,等.MasonⅠ、Ⅱ型桡骨头骨折非手术治疗的比较研究[J].中华手外科杂志,2005,21:151-153.
[6]蔡培华,梅国华,范存义,等.MasonⅢ型桡骨头骨折内固定的临床疗效[J]中华创伤骨科杂志,2005,7:496-498.
[7]IkedaM,SugiyamaK,KangC,etal.Comminutedfracturesoftheradialhead.Comparisonofresectionandinternalfixation[J].BoneJointSurgAm,2005,87:76-84.
[8]McKeeMD,PughDM,WildLM,etal.Standardsurgicalprotocoltotreatelbowdislocationswithradialheadandcoronoidfractures.Surgicaltechnique[J].BoneJointSurgAm,2005,87:22-32.
[9]HallJA,McKeeMD.Posterolateralrotatoryinstabilityoftheelbowfollowingradialheadresection[J].BoneJointSurgAm,2005,87:1571-1579.
[10]HarrintonIJ,Sekyi-OutA,BarringtonTW,etal.Thefunctionaloutcomewithmetallicradialheadimplantsinthetreatmentofunstableelbowfractures:along-termreview[J].Trauma,2001,50:46-52.