应用人工桡骨头假体置换治疗桡骨头粉碎骨折的研究

根据桡骨头的解剖形态和生理功能，用一定硬性和韧性的超高分子量聚已烯材料，做成不同大小、长短的人工桡骨头假体。临床上主要治疗桡骨头粉碎骨折。手术暴露取肘后外侧斜行切口，从肘肌与尺侧腕伸肌间切开肱桡关节囊，部分切断环状韧带，摘除粉碎的桡骨头。在桡骨上端截骨，并扩大其髓腔。将备好的桡骨头假体柄插入桡骨上端髓腔内，用骨水泥加固。作者从１９８９年起采用这种假体治疗桡骨头粉碎骨折３０例，经临床观察和生物力学检测，证明假体生物相容性良好，患肢功能恢复满意，疗效优良率为８６．７％，早期手术优良率为９５．８％。未发现假体变形、折断现象。假体置换稳定，避免了桡骨短缩上移和下桡尺关节半脱位等弊病。

TheProstheticReplacementforComminutedFracturesofRadialHead

Purpose:Totreatcomminutedfracturesoftheradialheadusingprostheticreplacement,inordertoimprovetheresultsoftreatment.Materialsandmethods:Accordingtotheanatomicalformandphysiologicalfunctionofradialhead,theprosthesiswasmadeofpolyethylenewithhardnessandtenacity.UsingBoydapproach,thesubcuta-neoustissueandthedeepfasciaweredividedalongthelineoftheincision,andthefascialplanebetweentheextensorcarpiulnarisandtheanconeusmuscleswasdeveloped.Partoftheannularligamentwasin-cised,andthentheradialheadwasresected.Themedularycavitywasenlargedbeforeinsertingtheprothesisandfixationwithcement.ResultsandConclusion:Since1989,theauthorhavetreated30comminutedfracturesoftheradialheadusingartificialradialheadprothesis.Byclinicalandbiomechanicalobservations,itwasfoundthatthebiocompatibilityoftheprothesiswasfavorable.Theexcelentandgoodresultswereseenin86.7%ofthecases,andthatofthecasesoperateduponearlywas95%.Theprotheticreplacementhasbeenfoundstable,withoutdistortionorbreakage.Theprocedureisagoodmeasureforthepreventionofra-dialshorteningandsubluxationofthedistalradio-ulnarjoint.