Effectiveness of internal fixation with headless compression hollow embedding screws for intraarticular fracture of elbow_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 DUAN Liang , GONG Liqun , FAN Yayi , QI Jie , LI Weiwei , WEI Wenbo , ZHAO Wei

Department of Orthopedics, Shaanxi People’s Hospital, Xi’an Shaanxi, 710068, P.R.China;

Corresponding author：

DUAN Liang, Email: duanliang0620@163.com

Keywords：

Headless compression hollow embedding screw; elbow; intraarticular fracture; internal fixation

DOI：

10.7507/1002-1892.201902058

Video：

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Abstract Full text Figures/Tables Video References Cited by

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.

Citation： DUAN Liang, GONG Liqun, FAN Yayi, QI Jie, LI Weiwei, WEI Wenbo, ZHAO Wei. Effectiveness of internal fixation with headless compression hollow embedding screws for intraarticular fracture of elbow. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(8): 986-990. doi: 10.7507/1002-1892.201902058 Copy

1.	Givissis PK, Symeonidis PD, Ditsios KT, et al. Late results of absorbable pin fixation in the treatment of radial head fractures. Clin Orthop Relat Res, 2008, 466(5): 1217-1224.
2.	Watts AC, Morris A, Robinson CM. Fractures of the distal humeral articular surface. J Bone Joint Surg (Br), 2007, 89(4): 510-515.
3.	陈志伟, 黄水兵, 吴文特, 等. 关节镜下埋头空心钉内固定治疗 Mason Ⅱ 型桡骨头骨折的疗效观察. 中国骨与关节损伤杂志, 2017, 32(9): 936-938.
4.	禹宝庆, 周成欢, 胡健, 等. 成人肱骨远端复杂骨折内固定治疗. 中华肩肘外科电子杂志, 2014, 2(1): 1-3.
5.	Koslowsky TC, Mader K, Kirchner S, et al. Treatment of medial malleolar fractures using fine-threaded K-wires: a new operative technique. J Trauma, 2007, 62(1): 258-261.
6.	O’Driscoll SW. Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg, 2005, 14(1 Suppl S): 186S-194S.
7.	Huang TL, Chiu FY, Chuang TY, et al. Surgical treatment of acute displaced fractures of adult distal humerus with reconstruction plate. Injury, 2004, 35(11): 1143-1148.
8.	黄雷, 张波, 王满宜, 等. 肱骨髁间骨折的手术治疗. 中华骨科杂志, 2001, 21(3): 158-162.
9.	曾凯生, 刘伟聪, 肖逸鹏, 等. 平行及垂直双钢板固定治疗成人肱骨远端髁间骨折疗效分析. 临床军医杂志, 2016, 44(4): 365-367.
10.	段鑫, 邹敏, 王俊博, 等. Kaplan 入路结合微型锁定钢板治疗肱骨远端冠状面骨折. 中华肩肘外科电子杂志, 2018, 6(4): 260-265.
11.	谢求恩, 谢心军, 徐永贵, 等. 可吸收棒内固定治疗肘关节内骨折的临床体会. 中国骨与关节损伤杂志, 2018, 33(1): 86-87.
12.	胡晓川, 向明, 杨国勇, 等. Dubberley 3B 型肱骨小头-滑车骨折的手术治疗. 中国修复重建外科杂志, 2014, 28(10): 1194-1198.
13.	张帆, 李北平, 刘洪全, 等. Herbert 加压螺钉治疗桡骨头骨折疗效分析. 中国修复重建外科杂志, 2012, 26(3): 375-376.
14.	王伟斌, 袁欣华, 郑轶, 等. Kaplan 入路联合前内侧入路治疗成人肱骨小头-滑车骨折. 中国骨伤, 2018, 31(12): 1148-1152.
15.	郭祁, 何大炜, 孙宁, 等. 创伤后肘关节僵硬 553 例回顾性分析. 中华外科杂志, 2015, 53(2): 85-89.
16.	万铖, 徐典康, 谢侃, 等. 肘关节骨折手术后异位骨化发生影响因素的 logistic 分析. 临床外科杂志, 2018, 26(7): 542-545.
17.	高继龙, 景珩. 异位骨化治疗进展. 国际骨科学杂志, 2017, 38(4): 251-254.
18.	何树坤, 黄富国. 创伤后肘关节异位骨化研究进展. 中国修复重建外科杂志, 2015, 29(6): 777-782.
19.	Foruria AM, Lawrence TM, Augustin S, et al. Heterotopic ossification after surgery for distal humeral fractures. Bone Joint J, 2014, 96-B(12): 1681-1687.

1. Givissis PK, Symeonidis PD, Ditsios KT, et al. Late results of absorbable pin fixation in the treatment of radial head fractures. Clin Orthop Relat Res, 2008, 466(5): 1217-1224.
2. Watts AC, Morris A, Robinson CM. Fractures of the distal humeral articular surface. J Bone Joint Surg (Br), 2007, 89(4): 510-515.
3. 陈志伟, 黄水兵, 吴文特, 等. 关节镜下埋头空心钉内固定治疗 Mason Ⅱ 型桡骨头骨折的疗效观察. 中国骨与关节损伤杂志, 2017, 32(9): 936-938.
4. 禹宝庆, 周成欢, 胡健, 等. 成人肱骨远端复杂骨折内固定治疗. 中华肩肘外科电子杂志, 2014, 2(1): 1-3.
5. Koslowsky TC, Mader K, Kirchner S, et al. Treatment of medial malleolar fractures using fine-threaded K-wires: a new operative technique. J Trauma, 2007, 62(1): 258-261.
6. O’Driscoll SW. Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg, 2005, 14(1 Suppl S): 186S-194S.
7. Huang TL, Chiu FY, Chuang TY, et al. Surgical treatment of acute displaced fractures of adult distal humerus with reconstruction plate. Injury, 2004, 35(11): 1143-1148.
8. 黄雷, 张波, 王满宜, 等. 肱骨髁间骨折的手术治疗. 中华骨科杂志, 2001, 21(3): 158-162.
9. 曾凯生, 刘伟聪, 肖逸鹏, 等. 平行及垂直双钢板固定治疗成人肱骨远端髁间骨折疗效分析. 临床军医杂志, 2016, 44(4): 365-367.
10. 段鑫, 邹敏, 王俊博, 等. Kaplan 入路结合微型锁定钢板治疗肱骨远端冠状面骨折. 中华肩肘外科电子杂志, 2018, 6(4): 260-265.
11. 谢求恩, 谢心军, 徐永贵, 等. 可吸收棒内固定治疗肘关节内骨折的临床体会. 中国骨与关节损伤杂志, 2018, 33(1): 86-87.
12. 胡晓川, 向明, 杨国勇, 等. Dubberley 3B 型肱骨小头-滑车骨折的手术治疗. 中国修复重建外科杂志, 2014, 28(10): 1194-1198.
13. 张帆, 李北平, 刘洪全, 等. Herbert 加压螺钉治疗桡骨头骨折疗效分析. 中国修复重建外科杂志, 2012, 26(3): 375-376.
14. 王伟斌, 袁欣华, 郑轶, 等. Kaplan 入路联合前内侧入路治疗成人肱骨小头-滑车骨折. 中国骨伤, 2018, 31(12): 1148-1152.
15. 郭祁, 何大炜, 孙宁, 等. 创伤后肘关节僵硬 553 例回顾性分析. 中华外科杂志, 2015, 53(2): 85-89.
16. 万铖, 徐典康, 谢侃, 等. 肘关节骨折手术后异位骨化发生影响因素的 logistic 分析. 临床外科杂志, 2018, 26(7): 542-545.
17. 高继龙, 景珩. 异位骨化治疗进展. 国际骨科学杂志, 2017, 38(4): 251-254.
18. 何树坤, 黄富国. 创伤后肘关节异位骨化研究进展. 中国修复重建外科杂志, 2015, 29(6): 777-782.
19. Foruria AM, Lawrence TM, Augustin S, et al. Heterotopic ossification after surgery for distal humeral fractures. Bone Joint J, 2014, 96-B(12): 1681-1687.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of internal fixation with headless compression hollow embedding screws for intraarticular fracture of elbow

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