Comparison Of The Clinical Efficacy Of Two Kinds Surgical Approach For Treatment Of Mason Type Ⅲ Radial Head Fractures

Objectives To compare the preliminary clinical efficacy of radial head resection and prosthetic peplacement for the treatment of Mason type Ⅲ radial head fractures,providing practical basis for the clinical choice.Methods Chooseing the patients of Mason type Ⅲ radial head fractures as the stydy objects,who undergo operation in the second hospital of Tangshan from 2006 September to 2014 June.Choose 55 patient cases through clear diagnostic criteria and strict inclusion and exclusion criteria in this study.Collection and record the related cases,imaging data,operation data and postoperative follow-up records,and carry on a retrospective statistical analysis.Divide these cases into two according to the different surgical methods.25 cases were treated by resecting radial head,and 30 cases were treated by artificial prosthesis replacement.Comparative analysis of the two groups of different time periods of the visual analogue scale(VAS),elbow joint activity,imaging results,Broberg and Morrey elbow score function,DASH score and complications.Results All the patients were followed-up for 12 to 18 months,an average of 14.56± 3.04 months.All patients had no infection,had no blood vessel or nerve injury.(1)Elbow pain relief,in 2 weeks the replacement group was batter than the resection group(P < 0.05).However,after 2 weeks,there are no significant difference(P >0.05).(2)Wrist pain,the replacement group was batter than the resection group(P < 0.05).(3)Elbow and forearm motion,the motion range of replacement group was greatly better than the resection group(P < 0.05).(4)carrying angle change,compared with the contralateral elbow,the increase of carrying angle increase in replacement group was obviously littler than the resection group(P < 0.05).(5)DASH points,the replacement group was less than the resection group(P < 0.05).(6)Broberg-Morrey score,the replacement group was higher than the resection group(P < 0.05),and at 12 months after operation,the superior rate of replacement group was 93.33%,resection group was 52.00%.(7)Complications,in resection group,10 cases appeared elbow stiff and with pain,8 cases appeared wrist pain,10 cases appeared elbow outway obviously.Through X-ray,12 cases appeared heterotopic ossification in the last follow-up.In replacement group,prosthetic position is good,no deformation,broken and loose,no obvious wear,there were no significant heterotopic ossification and arthritis.Conclusions In the treatment of comminuted radial head fractures,prosthesis replacement have more obvious advantage than resection in pain relief,function recovery,and reduce complications.Prosthesis replacement can reconstruct elbow joint stability,its short-term clinical efficacy is better than resection.