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桡骨小头/颈骨折 Radial Head / Neck Fracture

2009-11-30 guketiku.blog.hexun.com A +

ClassificationDefinitionClinicalCharacteristicsTreatmentTypeINondisplacedormildlydisplacedfracturesoftheradialheadorneckNomechanicalblockbutmayhavedecreasedpronationandsupinationsecondarytoacutepainand/orswellingRequiresearlymobilizationwithoutcasttreatmenttoavoidelbowandforearmcontracturesTypeIIDisplaced(>2mm)fracturesoftheheadorneck(angulated)Mayhaveincongruityatthefracturesiteandmechanicalblockagetomovement.Normallyencompassesmorethanamarginallipoftheradialhead.Lackseverecomminution.Usuallyrequireopenreductionandinternalfixation(ORIF)butmaybenefitfromexcisioninselectcircumstancessuchastheelderly.Ifradialneckcomminutionispresent,thenconsiderationofbonegraftingiswarranted.DuringtheORIFprocedure,careneedstobegiventoavoidingtheposteriorlateralcornertoavoidposteriorlateralelbowinstability.TypeIIISeverelycomminutedfractureoftheradialheadandneckAssociatedwithadjacentinjuriessuchasTFCCtears,IOLtearsoftheforearm,orelbowdislocations(usuallyposterior)withorwithoutcoronoidfractures.Needtobeexcisedforrestorationofforearmmovement.

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