目的：观察采用组配式桡骨头假体置换治疗MasonⅢ和Ⅳ型桡骨头骨折的早期疗效。方法：2009年1月至2012年3月，应用组配式桡骨头假体治疗16例MasonⅢ和Ⅳ型桡骨头骨折患者，男9例，女7例；年龄31～57岁，平均43岁。评价患者肘关节屈伸活动及前臂旋转活动范围，并根据Mayo肘关节功能评估评分（Mayo elbow perfor-mance score，MEPS）评价肘关节总体功能；对影像学进行测量，评价桡骨头假体高度及假体松动程度。结果：14例患者得到随访，时间12～33个月，平均23个月。关节活动范围与健侧比较，患侧肘关节屈伸度及前臂旋转活动度明显较差（P＜0．01）。MEPS评分90±16（45～100）；分级评定：优9例，良2例，可2例，差1例。按照Grewal分级，4例出现轻度的透亮线，1例中度透亮线。结论：组配式桡骨头假体置换治疗难以内固定可靠重建的MasonⅢ和Ⅳ型桡骨头骨折早期疗效满意，中、远期疗效仍有待于进一步研究。%Objective:To assess the early efficacy of metallic modular radial head prostheses in patients with MasonⅢandⅣunreconstructable radial head fractures. Methods:The medical records of 16 patients (9 males,7 females) with a mean age of 43 years old (31 to 57) with MasonⅢ/Ⅳunreconstructable radial head fractures requiring metallic modular radial head replacement between January 2009 and March 2012 ,were reviewed retrospectively. The functional results were assessed by range of movement,Mayo elbow performance score (MEPS). All patients underwent radiographic evaluation for radial head height and radiolucent lines. Results:Fourteen patients were evaluated with follow up for 12 to 33 months with an average of 23 months. Range of movement parameters was significantly lower in the affected elbow than in the unaffected side (P<0.01). MEPS results were excellent in 9 cases,good in 2 cases,fair in 2 cases,and poor in 1 case. According to Grewal grading,there were 4 cases of periprosthetic lucencies of the radius and 1 case had significant clinical signs of loosening. Conclusion:Radial head replacement with the metallic modular prostheses yields satisfactory results regarding range of motion and function of the elbow joint in short term. The evolution of this prostheses needs to be evaluated with further studies to assess mid term and long term follow up results.
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