<strong>Tóm tắt</strong> Chỏm quay được xem như một thành phần giữ vững của khớp khuỷu. Các mục tiêu điều trị gãy chỏm quay ngày càng hướng tới việc phục hồi chức năng và sự vững của khớp khuỷu. <em>Mục tiêu:</em> Đánh giá kết quả phẫu thuật kết hợp xương gãy chỏm quay Mason III, IV tại Bệnh viện Thống Nhất TPHCM. <em>Đối tượng và phương pháp nghiên cứu: </em>nghiên cứu mô tả tiến cứu 52 người bệnh (NB) gãy chỏm quay Mason III, IV do chấn thương được phẫu thuật kết hợp xương bằng nẹp vít và khóa tại Bệnh viện Thống Nhất từ 12/ 2018 đến 12/ 2023. <em>Kết quả: </em>tỷ lệ nữ (69,2%) nhiều hơn nam (30,8%). Tuổi trung bình 36 tuổi (từ 16 đến 59 tuổi). Nguyên nhân chấn thương gãy chỏm quay thường gặp nhất là tai nạn giao thông (75%). Hơn 80% NB gãy chỏm quay trong nhóm nghiên cứu có phân độ Mason III. NB có độ vững khuỷu bình thường sau mổ chiếm 90,4%. Đánh giá theo thang điểm Broberg và Morrey có 88,5% NB có kết quả chức năng rất tốt; 9,6% NB tốt; 1,9% NB trung bình và không có NB nào có kết quả xấu. 13,5% NB trong nghiên cứu bị biến chứng sau mổ bao gồm: 1,9% NB bị di lệch dụng cụ, 5,8% NB bị can lệch xương chỏm quay, 3,8% NB vừa bị can lệch vừa bị mất vững, 1,9% NB bị tổn thương thần kinh quay. <em>Kết luận:</em> các NB bị gãy chỏm quay Mason III, IV được mổ kết hợp xương bên trong, cho phép vận động sớm cẳng tay và khuỷu tay với chức năng tốt. <em>Từ khóa:</em> gãy chỏm quay, kết hợp xương chỏm quay, Mason III, IV. <strong> </strong> <strong>Evaluation of surgical fixation outcomes for Mason type III or IV radial head fracture</strong> Do Duy<sup>1</sup>, Vo Thanh Toan<sup>1</sup>, Nguyen Minh Duong<sup>1</sup>, Vo Toan Phuc<sup>2</sup> <ol> <li>Thong Nhat Hospital, 2. St. Mark's School</li> </ol> <strong>Abstract</strong> <em>Introduction: </em>The radial head is considered a stabilizing component of the elbow joint. Treatment goals for radial head fractures are to restore the function as well as to maintain stability of the elbow joint. <em>Objectives:</em> To evaluation of surgical fixation outcomes in Mason type III or IV radial head fracture at Thong Nhat Hospital, Ho Chi Minh City. <em>Patients and Methods:</em> a prospective descriptive study of 52 patients with radial head fractures due to trauma undergoing an open reduction, internal fixation surgery with plate and screws at Thong Nhat Hospital from December 2018 to December 2021. <em>Results: </em>The proportion of women (69%) was higher than that of men (31%). The average age was 36 years old (from 16 to 59 years old). The most common cause of radial head fractures is traffic accidents (75%). More than 80% of the patients with fractures of the radial head are Mason type III. Patients had normal elbow stability after surgery accounted for 90.4%. Evaluation according to the Broberg and Morrey scale, 88.5% of patients had very good functional results, 9.6% of patients were good, 1.9% of patients were moderate, but no patient had a bad outcome. 13.5% of patients in the study had postoperative complications including: implant displacement in 1.9%, radial head malunion in 5.8%, 3.8% patients were complicated for both dislocated and unstable, 1.9% of patients had radial nerve injury respectively. <em>Conclusions: </em>Patient with Mason type III and IV radial head fractures could be stabilized with open reduction and internal fixation surgery allowing early motion of the forearm and elbow with good function. <em>Keywords:</em> radial head fracture, fixation radial head, Mason III, IV. <strong>Tài liệu tham khảo</strong> <ol> <li>Juan M. Patiđo; Victoria P. Saenz. Radial Head Fractures. Treasure Island (FL): StatPearls Publishing; 2022 Jan.</li> <li>Izậk F Kodde, Laurens Kaas, Mark Flipsen, Michel PJ van den Bekerom, Denise Eygendaal. Current concepts in the management of radial head fractures. World J Orthop. 2015 Dec 18; 6(11): 954–960. doi: 10.5312/wjo.v6.i11.954.</li> <li>Morrey BF. The elbow and its disorders. 4th edn. Philadelphia (PA): Saunders/Elsevier; 2009:1211.</li> <li>Hackl M, Wegmann K, Hollinger B. et al. (2019). Surgical revision of radial head fractures: a multicenter retrospective analysis of 466 cases. J Shoulder Elbow Surg; 28(8): 1457-1467.</li> <li>Chen X, Wang SC, Cao LH. Et al. (2011). Comparison between radial head replacement and open reduction and internal fixation in clinical treatment of unstable, multi-fragmented radial gead fractures. Int Orthop; 35(7): 1071-6.</li> <li>Duckworth AD, Watson BS, Will EM. Et al. (2011). Radial head and neck fractures: functional results and presictors of outcome. J Trauma; 71(3): 643-8.</li> <li>Gregori M, Zott S, Hajdu S. et al. (2019). Preserving the radial head in comminuted Mason type III fractures without fixation to the radial shaft: a mid-term clinical and radiographic follow-up study. J Shoulder Elbow Surg; 28(11): 2215-2224.</li> <li>Gruszka D, Nowak TE, Tkacz T. et. Al. (2019). Complex radial head and neck fractures treated with morden locking plate fixation. J Shoulder Elbow Surg; 28(6): 1130-1138.</li> <li>Ikeda M, Sugiyama K, Kang C. et al. (2005). Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg Am; 87(1): pp. 76-84.</li> <li>Jiménez-Martin A, Contreras-Joya M, Navarro-Martinez S. et al. (2020). Clinical results of the radial arthroplasty in Hotchkiss terrible trial, a case series of 47. Rev Esp Cir Ortop Traumatol; 64(2): 83-91.</li> <li>Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002;84(10):1811–1815.</li> <li>Koslowsky TC, Mader K, Gausepohl T. et al. (2007). Reconstruction of Mason type-III and type-IV radial head fractures with a new fixation device: 23 patients followed 1-4 years. Acta Orthop; 78(1): 151-6.</li> <li>Nalbantoglu U, Kocaoglu B, Gereli A. et al. (2007). Open reduction and internal fixation of Mason type III radial head fractures with and without an associated elbow dislocation. J Hand Surg Am; 32(10): 1560-8.</li> <li>OConnor CM, Kortlever J, Vagner GA. Et al. (2020). Patient and Surgeon Factors Associated with Prosthetic Replacement Rather Than with Open Reduction and Internal Fixation of a Radial Head Fractures. Hand. PMID: 32432481.</li> <li>Ryu SM, Park SG, Kim JH. et al. (2018). Treatment of Modified Mason Type III or IV Radial Head Fracture: Open Reduction and Internal Fixation versus Arthroplasty. Indian J Orthop; 52(6): 590-595.</li> </ol> <!--more--><a href="https://vjsel.vn/wp-content/uploads/2025/02/Bai-10.pdf">Download file PDF</a>
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