何国彬　吴巧杏　吴起

【摘要】 目的：探讨桡骨近端骨折的损伤机制与骨折类型和合并伤的关系。方法：回顾性分析2014年1月-2018年12月本院就诊的50例桡骨近端骨折患者的临床资料。采用Mason分型对骨折类型进行区分，探讨桡骨近端骨折的损伤机制与骨折类型和合并伤的关系。结果：不同骨折类型的手部着地，外翻位摔倒情况比较，差异有统计学意义（P<0.05），且此损伤机制下以Ⅱ型骨折为主。不同骨折类型的肘部直接着地、跌落前受到强力牵拉以及硬物撞击情况比较，差异均无统计学意义（P>0.05）。不同损伤机制对是否伴有合并伤比较，差异有统计学意义（P<0.05）。结论：手部着地、外翻位摔倒是桡骨近端骨折的主要损伤机制，且损伤机制与伴有合并伤有关。

【关键词】 桡骨小头 桡骨颈 桡骨近端骨折 损伤机制

Relationship between Injury Mechanism of Proximal Radius Fracture and the Fracture Types and Complicated Injuries/HE Guobin， WU Qiaoxing， WU Qi. //Medical Innovation of China， 2021， 18（23）： -170

[Abstract] Objective： To explore the relationship between the injury mechanism of the proximal radius fracture and the fracture types and complicated injuries. Method： The clinical data of 50 patients with proximal radius fracture treated in our hospital from January 2014 to December 2018 were retrospectively analyzed. The Mason classification was used to distinguish the fracture types and to explore the relationship between the injury mechanism of the proximal radius fracture and the fracture types and complicated injuries. Result： There was significant difference in valgus fall among different fracture types （P<0.05）， and type Ⅱ fracture was the main injury mechanism. There were no significant differences in the direct landing， the strong pulling before falling and the impact of hard objects on the elbow of different fracture types （P>0.05）. There was significant difference among different injury mechanisms in the combination of injuries （P<0.05）. Conclusion： Hand landing and valgus fall are the main injury mechanism of the proximal radius fracture， and the injury mechanism is related to the complicated injuries.

[Key words] Radial capitulum Radial neck Proximal radius fracture Injury mechanism

First-author’s address： Leliu Hospital Affiliated to Shunde Hospital of Guangzhou University of Traditional Chinese Medicine， Foshan 528322， China

doi：10.3969/j.issn.1674-4985.2021.23.041

橈骨近端骨折是较为常见的肘关节损伤，并常伴有不同程度的软组织损伤[1-3]。近端桡骨包括盘状的桡骨小头和桡骨颈。桡骨小头上面为凹面，其直径略大于肱骨小头的直径，与肱骨小头形成肱桡关节，使得肱尺关节能自由活动。环绕在桡骨小头环状关节面的为环状韧带，其附着于尺骨并与桡尺骨紧密连接在一起，功能为使桡骨小头在其内部旋转，且在肘关节屈曲时避免桡骨小头脱位[4-9]。肘关节内侧副韧带（MCL）的前侧束是维持肘关节外翻稳定性的主要结构，桡骨近端骨折易造成MCL损伤，从而严重影响肘关节的稳定性[10-13]。桡骨近端骨折主要是摔倒后患者手掌撑地，此时前臂旋前且肘关节伸直，外翻力量轴向传递至肘关节，使桡骨小头与肱骨头发生撞击，从而造成桡骨小头或桡骨颈发生骨折，严重者还伴有MCL撕裂及肘关节脱位。……