创伤骨科医生对Mason Ⅱ型桡骨头骨折诊治现状的调查研究
A survey on the diagnosis and treatment of Mason Type Ⅱ radial head fracture by domestic orthopaedic trauma surgeons in China
李长润 1李庭 2孙志坚 2米萌 2肖鸿鹄 2季尚蔚 2姚东辰 2段芳芳 3蒋协远2
作者信息
- 1. 深圳市第二人民医院创伤骨科,深圳 518035
- 2. 北京积水潭医院创伤骨科,北京 100035
- 3. 北京积水潭医院临床流行病学研究室,北京 100035
- 折叠
摘要
目的 调查国内骨科医生诊治Mason Ⅱ型桡骨头骨折时的主要考虑因素.方法 于2022年1月15-16日采用便利抽样的调查方法对全国创伤骨科医生进行问卷调查,调查内容包括医生的基础信息、医生对Mason Ⅱ型桡骨头骨折的评估、医生的治疗倾向及认可的手术适应证等.结果 共获得474份有效问卷.358名医生(75.5％,358/474)认为Morrey等改良的Ⅱ型桡骨头骨折分型能够很好地指导治疗,460名医生(97.0％,460/474)认为需要联合肘关节X线片和CT检查诊断骨折情况.青年(80.2％,380/474)、优势侧受累(66.2％,314/474)、合并同侧上肢损伤(78.7％,373/474)、骨折移位大(67.7％,321/474)、骨折块与主骨分离(91.6％,434/474)以及骨折受累面积＞30％(81.6％,387/474)是创伤骨科医生选择手术治疗时主要考虑的因素.骨折移位大(71.7％,340/474)特别是关节面台阶移位大(83.5％,443/474)、骨折块与主骨分离(75.9％,360/474)以及查体发现前臂旋转受限或关节弹响(82.7％,392/474)是创伤骨科医生较为认可的Mason Ⅱ型骨折的手术指征.结论 对于存在骨性分离、骨折移位大,特别是关节面台阶大的桡骨头Mason Ⅱ型骨折患者,医生更倾向选择手术治疗.
Abstract
Objective To investigate the major considerations of domestic orthopaedic trauma surgeons in China when they diagnose and treat Mason type Ⅱ radial head fractures.Methods A questionnaire survey was conducted from January 15,2022 to January 16,2022 using the convenience sampling method among domes-tic orthopedic trauma surgeons in China.The survey covered the surgeons'basic information,evaluation of Mason type Ⅱ radial head fractures,treatment preferences,and surgical indications recognized.Results The pre-sent survey retrieved 474 eligible questionnaires.358 surgeons(75.5％,358/474)believed that the Morrey modified classification for Mason type Ⅱ radial head fracture could properly guide their diagnosis and treatment.460 surgeons(97.0％,460/474)believed that diagnosis of the fracture should be based on a combination of el-bow X-ray and elbow CT examinations.Young age(80.2％,380/474),dominant side involvement(66.2％,314/474),concomitant ipsilateral upper limb injury(78.7％,373/474),large fracture displacement(67.7％,321/474),separation of fracture fragments from the main bone(91.6％,434/474),and fracture in-volvement area＞30％(81.6％,387/474)were the main factors considered by the orthopedic trauma surgeons when they chose surgical treatment.Large fracture displacement(71.7％,340/474),especially large articular steps(83.5％,443/474),separation of fracture fragments from the main bone(75.9％,360/474),and limit-ed forearm rotation or joint clicking(82.7％,392/474)found during physical examination were recognized as surgical indications for Mason type Ⅱ fracture by orthopedic trauma surgeons.Conclusion Domestic ortho-pedic trauma surgeons in China prefer surgical treatment for Mason type Ⅱ radial head fractures with loss of corti-cal contact and large displacement,especially large articular steps.
关键词
桡骨骨折/问卷调查/医师诊疗模式/外科手术,选择性Key words
Radius fractures/Questionnaires/Physician's practice patterns/Surgical proce-dures,elective引用本文复制引用
基金项目
北京市医院管理局临床医学发展专项(扬帆计划)(ZLRK202311)
出版年
2024
NETL
NSTL
万方数据