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.	陳志偉, 黃水兵, 吳文特, 等. 關節鏡下埋頭空心釘內固定治療 Mason Ⅱ 型橈骨頭骨折的療效觀察. 中國骨與關節損傷雜志, 2017, 32(9): 936-938.
4.	禹寶慶, 周成歡, 胡健, 等. 成人肱骨遠端復雜骨折內固定治療. 中華肩肘外科電子雜志, 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.	黃雷, 張波, 王滿宜, 等. 肱骨髁間骨折的手術治療. 中華骨科雜志, 2001, 21(3): 158-162.
9.	曾凱生, 劉偉聰, 肖逸鵬, 等. 平行及垂直雙鋼板固定治療成人肱骨遠端髁間骨折療效分析. 臨床軍醫雜志, 2016, 44(4): 365-367.
10.	段鑫, 鄒敏, 王俊博, 等. Kaplan 入路結合微型鎖定鋼板治療肱骨遠端冠狀面骨折. 中華肩肘外科電子雜志, 2018, 6(4): 260-265.
11.	謝求恩, 謝心軍, 徐永貴, 等. 可吸收棒內固定治療肘關節內骨折的臨床體會. 中國骨與關節損傷雜志, 2018, 33(1): 86-87.
12.	胡曉川, 向明, 楊國勇, 等. Dubberley 3B 型肱骨小頭-滑車骨折的手術治療. 中國修復重建外科雜志, 2014, 28(10): 1194-1198.
13.	張帆, 李北平, 劉洪全, 等. Herbert 加壓螺釘治療橈骨頭骨折療效分析. 中國修復重建外科雜志, 2012, 26(3): 375-376.
14.	王偉斌, 袁欣華, 鄭軼, 等. Kaplan 入路聯合前內側入路治療成人肱骨小頭-滑車骨折. 中國骨傷, 2018, 31(12): 1148-1152.
15.	郭祁, 何大煒, 孫寧, 等. 創傷后肘關節僵硬 553 例回顧性分析. 中華外科雜志, 2015, 53(2): 85-89.
16.	萬鋮, 徐典康, 謝侃, 等. 肘關節骨折手術后異位骨化發生影響因素的 logistic 分析. 臨床外科雜志, 2018, 26(7): 542-545.
17.	高繼龍, 景珩. 異位骨化治療進展. 國際骨科學雜志, 2017, 38(4): 251-254.
18.	何樹坤, 黃富國. 創傷后肘關節異位骨化研究進展. 中國修復重建外科雜志, 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. 陳志偉, 黃水兵, 吳文特, 等. 關節鏡下埋頭空心釘內固定治療 Mason Ⅱ 型橈骨頭骨折的療效觀察. 中國骨與關節損傷雜志, 2017, 32(9): 936-938.
4. 禹寶慶, 周成歡, 胡健, 等. 成人肱骨遠端復雜骨折內固定治療. 中華肩肘外科電子雜志, 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. 黃雷, 張波, 王滿宜, 等. 肱骨髁間骨折的手術治療. 中華骨科雜志, 2001, 21(3): 158-162.
9. 曾凱生, 劉偉聰, 肖逸鵬, 等. 平行及垂直雙鋼板固定治療成人肱骨遠端髁間骨折療效分析. 臨床軍醫雜志, 2016, 44(4): 365-367.
10. 段鑫, 鄒敏, 王俊博, 等. Kaplan 入路結合微型鎖定鋼板治療肱骨遠端冠狀面骨折. 中華肩肘外科電子雜志, 2018, 6(4): 260-265.
11. 謝求恩, 謝心軍, 徐永貴, 等. 可吸收棒內固定治療肘關節內骨折的臨床體會. 中國骨與關節損傷雜志, 2018, 33(1): 86-87.
12. 胡曉川, 向明, 楊國勇, 等. Dubberley 3B 型肱骨小頭-滑車骨折的手術治療. 中國修復重建外科雜志, 2014, 28(10): 1194-1198.
13. 張帆, 李北平, 劉洪全, 等. Herbert 加壓螺釘治療橈骨頭骨折療效分析. 中國修復重建外科雜志, 2012, 26(3): 375-376.
14. 王偉斌, 袁欣華, 鄭軼, 等. Kaplan 入路聯合前內側入路治療成人肱骨小頭-滑車骨折. 中國骨傷, 2018, 31(12): 1148-1152.
15. 郭祁, 何大煒, 孫寧, 等. 創傷后肘關節僵硬 553 例回顧性分析. 中華外科雜志, 2015, 53(2): 85-89.
16. 萬鋮, 徐典康, 謝侃, 等. 肘關節骨折手術后異位骨化發生影響因素的 logistic 分析. 臨床外科雜志, 2018, 26(7): 542-545.
17. 高繼龍, 景珩. 異位骨化治療進展. 國際骨科學雜志, 2017, 38(4): 251-254.
18. 何樹坤, 黃富國. 創傷后肘關節異位骨化研究進展. 中國修復重建外科雜志, 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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