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[目的]评价并比较 Mason Ⅲ型或Ⅳ型桡骨头骨折行切开复位内固定术及桡骨头切除术的治疗效果,为选择桡骨头骨折治疗方法提供参考.[方法]桡骨头骨折21例,行桡骨头切除9例( Ⅲ型 5 例 ,Ⅳ型4例);切开复位钢板螺钉内固定12例( Ⅲ型 7 例 ,Ⅳ型5例,其中钢板螺钉内固定9例,螺钉内固定3例).术后根据肘关节活动度、肘关节提携角变化和桡骨移位、VAS 疼痛评分、患者对治疗效果的主观评价和 Broberg&Morrey 肘关节功能评分等进行疗效评定.[结果]平均随访时间29个月(12~60个月),所有患者骨折均愈合.切开复位内固定组及桡骨头切除组肘关节屈曲伸直弧度(130°±22.9° vs 78°±30.6°);提携角变化(2°±2.1° vs 9°±5.6°)、桡骨移位[(0.4 ± 0.3)mm vs (2.7±1.6)mm)]、VAS 疼痛评分[(0.9 ± 0.2)分 vs (4.6 ± 2.3)]和患者满意度[(9.3±1.4)分 vs (6.9 ± 2.6)分],比较差异均有统计学意义( P < 0.01);Broberg& Morrey 肘关节功能评分:切开复位内固定组平均(92.6±13.4)分,优7例,良3例,可2例,差0例;桡骨头切除组平均(70.8±19.6)分,优1例,良2例,可3例,差3例.两组比较,差异有统计学意义( P < 0.01).[结论]切开复位内固定是桡骨头 Mason Ⅲ型 、Ⅳ型骨折,可以获得比桡骨切除更好的肘关节功能,较少的并发症,注意术中术后的正确处理是手术成功的关键.“,”Objective] To evaluate and compare the efficacy of open reduction internal fixation vs radial head resection for the treatment of Mason Ⅲ or Ⅳ radial head fractures so as to provide the reference for the choice of operation methods of radial head fracture .[Methods]A total of 21 patients with Mason type Ⅲ or Ⅳ radial head fractures were enrolled in the study .Nine patients(5 cases of Mason type Ⅲ and 4 cases of Mason type Ⅳ ) underwent radial head resection .Twelve patients(7 cases of Mason type Ⅲ and 5 cases of Mason type Ⅳ ) received open reduction and internal fixation including nail and plate fixation in 9 patients and screw fixation in 3 patients .The outcomes were assessed through the range of motion ,the carrying angle change of elbow joint ,shift of radius ,visual analogous scale(VAS) of pain ,patient satisfaction and Broberg & Morrey elbow perform‐ance score .[Results] The mean follow up was 29 months(12 ~ 60 months) .All fractures were healed .There were significant differences in the range of flexion and extension arc at the elbow joint (130° ± 22 .9° vs 78° ± 30 .6°) ,the carrying angle change (2° ± 2 .1° vs 9° ± 5 .6°) ,shift of radius(0 .4 ± 0 .3mm vs 2 .7 ± 1 .6mm) ,VAS of pain(0 .9 ± 0 .2 vs 4 .6 ± 2 .3) and patient sat‐isfaction(9 .3 ± 1 .4 vs 6 .9 ± 2 .6) between open reduction internal fixation group and radial head resection group ( P < 0 .01) .In open reduction internal fixation group ,the mean Broberg & Money elbow performance score was 92 .6 ± 13 .4 ,and 7 patients were excellent ,and 3 patients were good ,and 2 patients were fair ,and no patient was poor .In radial head resection group ,the mean Broberg & Money elbow performance score was 70 .8 ± 19 .6 ,and one patient was excellent ,and 2 patients were good , and 3 patients were fair ,and 3 patients were poor .There was significant difference in Broberg & Money elbow performance score between two groups( P < 0 .01) .[Conclusion] Compared with radial head resection ,open reduction internal fixation for the treatment of Mason type Ⅲ or Ⅳ radial head fractures can obtain the better elbow function and less complication than radial head resection .Paying attention to the correct intraoperative and postoperative management is the key to obtain the successful surgery .