目的:比较组合压配型桡骨头假体置换与切开复位钢板螺钉内固定治疗成人Mason Ⅲ型桡骨头骨折的临床疗效。方法:对2012年1月至2019年12月首都医科大学附属北京友谊医院收治的64例成人Mason Ⅲ型桡骨头骨折患者临床资料进行回顾性分析。男18例，女46例；年龄32~58岁，平均45.7岁。根据治疗方式不同分为2组：内固定组(mini钢板螺钉内固定32例）和置换组(组配型人工桡骨头假体置换32例）。末次随访时记录并比较肘关节外翻角度、肘关节活动范围、肘关节功能Mayo评分以及疼痛视觉模拟(VAS)评分，以评价术后疗效。结果:内固定组和置换组患者术前一般资料比较差异均无统计学意义（n P>0.05），具有可比性。所有患者术后获8~48个月（平均18.7个月）随访。内固定组和置换组手术时间分别为（81.4±8.2）、（68.9±7.3）min，差异有统计学意义（n P<0.05）。末次随访时内固定组和置换组屈伸角度分别为95°~125°、100°~140°；旋转角度分别为135.3°±11.2°、143.5°±12.8°，Mayo评分分别为（79.2±3.8）、（83.4±3.9）分，以上项目置换组均优于内固定组，差异均有统计学意义（n P<0.05）。内固定组术前和末次随访时疼痛VAS分别为（7.6±0.7）、（0.9±0.7）分；置换组术前和末次随访时疼痛VAS分别为（7.9±0.8）分、（0.7±0.6）分，两组组内术前与末次随访时比较差异均有统计学意义（n P0.05). All patients were followed up for 8 to 48 months (average, 18.7 months). The operation time was, respectively, (81.4±8.2) min and (68.9±7.3) min for the internal fixation group and the replacement group, showing a statistically significant difference (n P< 0.05). For the internal fixation group and the replacement group at the last follow-up, the flexion and extension angles were 95° to 125° and 100° to 140°, the rotation angles 135.3°±11.2° and 143.5°±12.8°, and the Mayo scores 79.2±3.8 and 83.4±3.9, all significantly favoring the replacement group (n P<0.05). The VAS pain scores before operation and at the last follow-up were 7.6±0.7 and 0.9±0.7 for the internal fixation group, and 7.9±0.8 and 0.7±0.6 for the replacement group, showing significant differences between preoperation and the last follow-up in both groups (n P<0.05). All the incisions healed by the first intention, with no postoperative infection. Internal fixation loosening with ulnar neuritis was reported in one case in the internal fixation group; peri-prosthesis absorption with no prosthesis loosening was observed in one case in the replacements group.n Conclusion:In the treatment of adult Mason Ⅲ radial head fractures, although both replacements with a composite press-fit radial head prosthesis and open reduction and plate-screw internal fixation can lead to satisfactory results, the former may be more effective.