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Clinical effect of reconstructing irreducible comminuted radial head fracture with autogenous iliac bone graft |
ZHANG Rui LEI Yihao HU Xingxi HOU Kaiyu |
Department of Bone and Trauma Surgery, the Fourth Affiliated Hospital of Kunming Medical University, Yunnan Province, Kunming 650021, China |
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Abstract Objective To investigate the clinical effect of reconstructing irreducible comminuted radial head fracture with autogenous iliac bone graft. Methods A total of 27 patients with Mason type Ⅲ and type Ⅳ comminuted radial head fracture admitted to the Fourth Affiliated Hospital of Kunming Medical University from June 2016 to June 2019 were selected as the research subjects. The comminuted radial head fractures were all surgically reconstructed with autogenous iliac bone. All patients were followed up for more than 12 months. Heal, Broberg-Morrey elbow fracture outcome score, and disability of arm, shoulder and hand scale (DASH) score were recorded at the last follow-up. The range of motion of the elbow of the affected side and the healthy side was compared in the same patient at the last follow-up. Results At the last follow-up, X-ray graphs showed that 25 patients had bony healing of the radial head. The bony healing rate was 92.6%, and the mean healing time was (11.35±1.15) weeks. At the last follow-up, the excellent and good rate of Broberg-Morrey elbow fracture outcome score was 88.9%, and the average DASH scale score was (15.52±4.39) points. At the last follow-up, the flexion and extension, pronation and supination range of motion of the elbow of the affected side was lower than that of the healthy side, and the differences were statistically significant (all P < 0.05). Conclusion Reconstruction of irreducible comminuted radial head fractures with autogenous iliac bone graft can achieve satisfactory results in the short and medium term, but the long-term results need to be further studied.
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[1] Khawar H,Craxford S,Ollivere B. Radial head fractures [J]. Br J Hosp Med (Lond),2020,81(4):1-6.
[2] 王洪根,林艺靖,杨博宇,等.桡骨头切除术治疗严重粉碎性桡骨头骨折的疗效观察[J].中国骨与关节损伤杂志,2019,34(3):310-311.
[3] 李贵山,邱小魁,方永刚.桡骨头置换治疗桡骨头粉碎性骨折的临床经验[J].中国矫形外科杂志,2017,25(17):1627-1629.
[4] 杨颇,宋开芳,秦杰,等.手术松解联合外支架治疗伴疼痛的肘关节功能障碍近期疗效观察[J].重庆医学,2017, 46(8):1063-1065,1069.
[5] Alexander T,Azar FM,Mauck B,et al. The effect of humeral rotation on elbow range-of-motion measurements [J]. Am J Orthop(Belle Mead NJ),2015,44(2):73-76.
[6] Angst F,Schwyzer HK,Aeschlimann A,et al. Measures of adult shoulder function:Disabilities of the Arm,Shoulder,and Hand Questionnaire(DASH)and its short version(QuickDASH),Shoulder Pain and Disability Index(SPADI),American Shoulder and Elbow Surgeons(ASES)Society standardized shoulder assessment form,Constant (Murley)Score(CS),Simple Shoulder Test(SST),Oxford Shoulder Score(OSS),Shoulder Disability Questionnaire(SDQ),and Western Ontario Shoulder Instability Index(WOSI)[J]. Arthritis Care Res(Hoboken),2011,63(S11):S174-S188.
[7] Broberg MA,Morrey BF. Results of delayed excision of the radial head after fracture [J]. J Bone Joint Surg Am,1986,68(5):669-674.
[8] 梁伟,李青松,宋开芳,等.保守治疗单纯稳定的桡骨头骨折[J].中国矫形外科杂志,2020,28(4):369-371.
[9] 赵福龙,王雪飞,张亚奎,等.经皮撬拨复位无头加压螺钉与切开复位微T形钛板内固定治疗Mason Ⅱ型桡骨头骨折疗效比较[J].中国骨与关节损伤杂志,2019,34(3):312-314.
[10] Jung KJ,Nho JH,Wang SD,et al. Metallic Press-fit Radial Head Replacement for Radial Head Fractures [J]. Orthopedics,2019,42(6):e545-e551.
[11] Wilps T,Kaufmann RA,Yamakawa S,et al. Elbow Biomechanics:Bony and Dynamic Stabilizers [J]. J Hand Surg Am,2020,45(6):528-535.
[12] 刘振宇,高化,李亚东,等.人工桡骨头置换术治疗Mason Ⅲ型桡骨头骨折的疗效分析[J].中国骨与关节损伤杂志,2018,33(11):1211-1212.
[13] Cristofaro CD,Carter TH,Wickramasinghe NR,et al. High Risk of Further Surgery After Radial Head Replacement for Unstable Fractures:Longer-term Outcomes at a Minimum Follow-up of 8 Years [J]. Clin Orthop Relat Res,2019,477(11):2531-2540.
[14] Duckworth AD,Wickramasinghe NR,Clement ND,et al. Radial head replacement for acute complex fractures:what are the rate and risks factors for revision or removal?[J]. Clin Orthop Relat Res,2014,472(7):2136-2143.
[15] 袁秋文,田烨.人工桡骨头置换术治疗粉碎性桡骨头骨折的临床应用[J].透析与人工器官,2020,31(2):36-38.
[16] Lalone EA,Deluce SR,Shannon H,et al. Design of Anatomical Population-Based and Patient-Specific Radial Head Implants [J]. J Hand Surg Am,2017,42(11):924.e1-924.e11.
[17] 胡昌希,撒柯狄,邓人富.自体髂骨板移植修复距骨滑车缺损[J].骨与关节损伤杂志,2004(11):785-786.
[18] 罗柏清,李祥,卢东辉,等.自体带骨膜髂骨板移植修复桡骨远端骨折并软骨缺损[J].中国骨与关节损伤杂志,2012,27(11):1046-1047.
[19] 罗柏清,卢东辉,何辉,等.自体带骨膜髂骨板移植修复桡骨头骨折并软骨面缺损[J].中国骨与关节损伤杂志,2015,30(3):317-318.
[20] 罗柏清,撒柯狄,卢东辉.自体带骨膜髂骨板移植修复髌骨粉碎性骨折合并软骨面缺损[J].中国骨与关节损伤杂志,2009,24(10):950-951.
[21] 杨颇,宋开芳,秦杰,等.肱骨外上髁骨移植修复难复性桡骨头粉碎性骨折的临床效果观察[J].中国现代医学杂志,2017,27(24):121-124.
[22] 谈宜,许景艺,陈俊岭,等.自体髂骨再造桡骨头维持肘关节稳定的生物力学研究[J].生物骨科材料与临床研究,2012,9(3):31-35,66.
[23] 谈宜,汪滋民,陈俊岭,等.自体髂骨再造桡骨头维持肘关节稳定的实验研究[J].中国骨与关节损伤杂志,2017, 32(3):269-271.
[24] 李凯,叶招明,张中伟,等.自体骨移植治疗四肢骨折术后骨不连失败因素分析[J].中国骨伤,2013,26(4):272-276.
[25] 刘晓宁,孔德明,仝超,等.锁定钢板内固定治疗成人Mason Ⅱ型桡骨头骨折疗效分析[J].中国骨与关节损伤杂志,2019,34(9):990-991.
[26] 李善庆,任义军,韩琼,等.桡骨头骨折块体积与手术方法的相关性[J].中华创伤骨科杂志,2019(5):422-426. |
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