Objective: To evaluate the effectiveness of internal fixation with headless compression hollow embedding screws in the treatment of intraarticular fracture of elbow.
Methods: Between March 2012 and September 2018, 12 patients with intraarticular fracture of elbow were treated with internal fixation with headless compression hollow embedding screws. There were 7 males and 5 females with an average age of 50.3 years (range, 22-65 years). Cause of injury included falling in 7 cases, falling from high places in 4 cases, and traffic accident in 1 case. Ten patients were distal humerus fractures which were classified as type 13-B3 in 8 cases and type 13-C3 in 2 cases according to the International Association of Internal Fixation Research (AO/ASIF). Two patients were radial head fractures which were classified as type Ⅲ according to the modified Mason classifications. The preoperative visual analogue scale (VAS) score was 8.25±0.83. The time from injury to operation was 3-5 days (mean, 3.7 days).
Results: All incisions healed by first intention. All 12 patients were followed up 6-15 months, with an average of 8.4 months. The results of X-ray films and CT examination showed that the fracture ends were anatomic reduction, and the fractures healed at 6-11 months after operation, with an average of 7.8 months. One patient had heterotopic ossification at 4 months after operation. The VAS scores were 5.17±0.79 at 2 weeks after operation and 0.50±0.50 at last follow-up. There were significant differences between the time points ( P<0.05). At last follow-up, the Mayo elbow function score was 68-95, with an average of 83.9. The activity of elbow joint recovered.
Conclusion: The intraarticular fracture of elbow can be firmly fixed by the headless compression hollow embedding screw, which can allow the early functional training of the elbow joint, reduce the incidence of heterotopic ossification, and obtain good effectiveness.
目的: 探讨无头加压中空埋入螺钉内固定治疗肘关节内骨折的疗效。.
方法: 2012 年 3 月—2018 年 9 月，采用无头加压中空埋入螺钉内固定治疗 12 例肘关节内骨折。男 7 例，女 5 例；年龄 22～65 岁，平均 50.3 岁。致伤原因：摔伤 7 例，高处坠落伤 4 例，交通事故伤 1 例。肱骨远端骨折 10 例，按照国际内固定研究协会（AO/ASIF）分型 13-B3 型 8 例、13-C3 型 2 例；桡骨头骨折 2 例，按照改良 Mason 分型均为 Ⅲ 型。术前疼痛视觉模拟评分（VAS）为（8.25±0.83）分。受伤至手术时间为 3～5 d，平均 3.7 d。.
结果: 术后切口均 Ⅰ 期愈合。12 例均获随访，随访时间 6～15 个月，平均 8.4 个月。X 线片及 CT 复查显示，骨折端解剖复位，术后 6～11 个月骨折均达骨性愈合，平均 7.8 个月；1 例术后 4 个月出现异位骨化。术后 2 周 VAS 评分为（5.17±0.79）分，末次随访时为（0.50±0.50）分，手术前后各时间点间比较差异均有统计学意义（ P<0.05）。末次随访时，Mayo 肘关节功能评分为 68～95 分，平均 83.9 分。肘关节活动度恢复良好。.
结论: 采用无头加压中空埋入螺钉内固定肘关节内骨折牢固，允许术后早期肘关节功能训练，异位骨化发生率低，可获得较好疗效。.
Keywords: Headless compression hollow embedding screw; elbow; internal fixation; intraarticular fracture.