Retrospective Analysis Of Mason Type ? Radial Head Fractures With Prosthetic Replacement And Open Reduction And Internal Fixation

Objective: The relief of symptoms and functional recovery of elbow joint for the treatment of Mason type III radial head fractures,with prosthetic replacement and open reduction and internal fixation were analyzed retrospectively.The short-term clinical effects of treatment of Mason type III radial head fractures after two kinds of operation were evaluated to provide a reliable basis for choosing the better clinical treatment for Mason type III radial head fracturesMethod: 1.The clinical data of Mason type III radial head fractures,with prosthetic replacement and open reduction and internal fixation from Dalian Medical University Affiliated Second Hospital of or thopaedic trauma since August 2011-August 2014 were analyzed retrospectively.28 patients were treated with prosthetic replacement(prosthetic replacement group),15 male patients,13 female patients,16 left radial head fracture,12 right radial head fracture,aged 35-62,average 47.6,all are the Mason type III radial head closed fresh fracture,16 falls,7 high fall injury,5 traffic accident injury,13 with elbow dislocation,5 with ligament injury,10 simple comminuted radial head fractures,injury to operation time 1-4 days,average 2.5 days;25 patients were treated with open reduction and internal fixation(open reductiongroup),14 male patients,11 female patients,10 left radial head fractures,15 right radial head fractures,age 23-57,the average age 43.5,all are the Mason type III radial head closed fresh fractures;14 falls,6 high fall injury,5 traffic accident injury,12 with elbow dislocation,2 with ligament injury,11 simple comminuted radial head fractures,injury to operation time 1-5 days,average 2.8 days.2.The prosthetic replacement group and open reduction group in gender,age,laterality,cause of injury,disease and other clinical data were compared,and observe the difference is statistically significant.3.The prosthetic replacement group and open reduction group were followed up after operations,it includes observe patients grip and forearm rotation strength and elbow flexion angle and range of motion,review postoperative elbow positive side wall X-ray,observation of the healing of fracture,internal fixation material is fixation and arthroplasty prosthesis loosening or other dislocations,then I use SPSS18.0 statistical software to collect data analysis,measurement data with mean±standard deviation by t-test,count data using ?2-test,if P<0.05 the difference has statistical significance,the elbow function of the two groups were evaluated by Broberg and Morrey elbow function score.Results: 1.The general clinical data has no statistically significance(P>0.05)in the two groups of patients.2.Follow-up visits to the patients in different groups from 12 months to 39 months were paid and the mean time of follow-up visits was 27 months.All the patients in the two different groups were healing well,and had no neurological deficit,metal allergy,cubitus valgus extension or any other complications.3.There is one has heterotopic ossification in the group of prosthetic replacement and no heterotopic ossification in the group of open reduction.There is no statistically significance(P>0.05)in the difference of the two groups 4.according to Broberg and Morreys' standard evaluation of elbow function,the final score of prosthetic replacement group is(86.5±9.6)and the open reductiongroup is(71.2±8.4).The final score of prosthetic replacement group is apparently higher than the group of open reduction which has statistically significance(P<0.05).There were 17 cases excellent,6 cases good,4 cases better and 1 case poor in the group of prosthetic replacement,the excellent rate is 82.1%.Mean while,there were 11 cases excellent,4 cases good,7 cases better and 3 cases poor in the group of pen reduction,the excellent rate is 60.0%.Conclusions: In the treatment of Mason type III radial head fractures,comparing with open reduction,prosthetic replacement has obvious advantage in the carrying angle and range of movement of the elbow joint.Prosthetic replacement has great effect in the early and middle phase of clinical curative effects evaluation.It is considered when treating with Mason type III radial head fractures,the head of radius prosthetic replacement should be used first to make sure the biomechanical stability and the integrity function of the elbow joint.