桡骨头体外重建

Kow Ren Yi, Zaharul Azri Mustapha Zakaria, Ruben Jaya Kumar, Low Chooi Leng, Khairul Nizam Siron Baharom
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引用次数: 0

摘要

桡骨头骨折在成人中很常见。桡骨头是桡骨的重要稳定器,尤其是在前臂旋前和旋前时。Mason III型桡骨头骨折的手术治疗包括桡骨头切除、桡骨头置换术及切开复位内固定。对于接受桡骨头切除术的患者,桡骨可能向近端移动,引起并发症,如手腕、前臂和肘部的慢性疼痛。另一方面,桡骨头置换术具有较高的翻修率和切除率。因此,可行时首选切开复位内固定。由于桡骨头碎片严重移位和手术空间有限,这在技术上要求很高。K先生,一名三十岁的体力工人,据称在跌倒后右桡骨头闭合性骨折梅森III型。桡骨头向前移位。术中取出桡骨头套,在体外重建,并用微型钢板固定。患者随后恢复,功能良好。桡骨头体外重建的新技术为外科医生提供了一个可行的选择,在肘关节功能方面具有相似甚至更好的结果。
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Extracorporeal Reconstruction of the Radial Head
Radial head fractures are common in adults. The radial head acts as an important stabilizer of the radius, especially during the forearm pronation and supination. Surgical treatment of Mason type III fracture of the radial head includes radial head excision, radial head replacement and open reduction and internal fixation. For patients treated with radial head excision, the radius might migrate proximally, causing complications such as chronic pain at the wrist, forearm, and elbow. On the other hand, radial head arthroplasty is associated with a high revision and removal rate. Hence, openreduction and internal fixation are preferred when feasible. This is technically demanding due to the severe displacement of the radial head fragments and limited surgical space. Mr K, a 30-year-old manual worker sustained a closed right radial head fracture Mason type III after an alleged fall. The radial head was displaced anteriorly. Intra-operatively, the radial headpieces were retrieved and were reconstructed extracorporeal and fixed with a miniplate. The patient subsequently recovered with good function. The new technique of extracorporeal reconstruction of the radial head offers a viable option to the surgeon with similar, or even better, outcomes in terms of elbow function.
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