1 2 PreoperativeAPradiographofaType2radialheadfracture 3 PreoperativelateralradiographofaType2radialheadfracture 4 PreoperativelateralradiographoftheType2radialheadfracture 5 Theelbowisflexedandpositionedonaradiolucenttable Theincisionbeginsjustabovethelateralepicondyleandextendsdowntowardstheulna passingdirectlyovertheradialhead asdepicted 6 Theskinincisionisbroughtdownthroughthesubcutaneoustissueandthecommonextensororiginisidentified 7 Thecommonextensororiginisincisedbetweentheanconeusandtheextensorcarpiulnarisoverthecapitellumradialhead ANCONEUS ECU 8 Theupperedgeofthecapitellumandtheradialheadareexposed 9 RADIALHEAD 10 Withsharpretractionandrotationoftheradialhead thefractureisidentified Caremustbetakennottoextendthisincisiontoofardistally asthismaydamagetotheposteriorinterosseousnerve asitlayovertheradialneck ANNULARLIGAMENT RADIALHEADFRACTURE 11 AFreerelevatororsmallosteotomeisintroducedtomobilizetheradialheadfracture 12 13 Closeupview CAPITELLUM RADIALHEAD 14 Afteranatomicreductionisachieved K wiresareusedtomaintainthereduction K WIRE REDUCTION 15 Afteranatomicreductionisachieved K wiresareusedtomaintainthereduction K WIRE REDUCTION 16 Usingtheexternaljig ascrewisplacedsuchthatitiscountersunkbelowthearticularsurfaceoftheradialhead Inthisexample asolidHerbertscrewisutilized 17 Thereducedandfixedradialhead TheHerbertscrewseatedunderthearticularsurface Occasionally thesecondK wireisexchangedforaHerbertscrew FRACTURE HERBERTSCREW 18 Therangeofmotionoftheforearmaswellaspronationandsupinationareconfirmed andthereductionisvisualizedthroughoutinarcofmotionoftheelbow Ifadequatelyfixedandstable closureisperformed FRACTURE HERBERTSCREW 19 Thecommonextensormechanismisbroughttogether enclosedovertheradio capitellarjoint 20 Afterclosure 21 Lateralview demonstratingthereduction 个人观点供参考 欢迎讨论