尺骨鹰嘴骨折钢丝环形加“8”字内固定的实验研究及其临床应用  

Experimental and clinical study of “8”-shape and circular wiring to treat fracture of olecranon

作　　者：李炜明[1] 王武炼[1] 翁绳健[1] 李坚[1] 陈国龄[1] 陈日齐[2] 

机构地区：[1]福州市第二医院骨科,福州市仓山区上藤路47号350007 [2]福州大学,350003

出　　处：《中国矫形外科杂志》2007年第6期411-414,共4页Orthopedic Journal of China

摘　　要：[目的]本课题通过比较尺骨鹰嘴骨折钢丝环形加“8”字与常用的4种内固定的稳定性,探讨尺骨鹰嘴骨折不同内固定的生物力学效应,旨在寻求尺骨鹰嘴骨折理想的内固定方式,为临床选择内固定提供实验依据,从而验证和指导临床治疗。[方法]采用20只成年男性肘关节新鲜尸体标本,建立横形、斜形、粉碎形三种不同模型尺骨鹰嘴骨折模型,分别采用钢丝环形、钢丝“8”字、钢丝环形加“8”字、克氏针张力带及螺丝钉5种不同方法进行内固定,使固定的肘关节标本屈曲90°,运用高精度位移传感器对固定性能进行测量。[结果]位移-载荷关系表明,单环形钢丝固定强度最小,钢丝环形加“8”字比单“8”字钢丝及螺丝钉强,统计学上差异显著(P<0.05);在横形、斜形骨折模型中,钢丝环形加“8”字组与克氏针张力带组相差不显著(P>0.05),但在粉碎性骨折模型中,钢丝环形加“8”字组与克氏针张力带组有显著性差异(P<0.05);临床应用26例中,全部愈合,平均随访12个月,优良率达92.30%。[结论]钢丝环形加“8”字内固定可用于治疗横、斜形及粉碎性尺骨鹰嘴骨折,对粉碎性骨折效果优佳,且创伤小、操作简便、固定牢靠,是一种安全可靠,值得临床推广应用的内固定方法。[ Objective] To evaluate the rigidity of ＂8＂-shape and circular wiring （FECW）compared with the other four common techniques of internal fixation,meanwhile to probe into their biomechanical effect,then to search the ideal and practical way of internal fixation of olecranon fracture,which can provide experimental data in selecting the internal fixation, then testify and guide the clinical treatment of olecranon fracture. [ Method] Twenty fresh cadaveric elbow joints were made into transverse, oblique and comminuted fracture models. The movement of fracture in 90 degree flexion sited with a acute bending moment to the ulna was tested in five techniques of the internal fixation. [ Result] Load-strain assessment showed that the rigidity of internal fixation of the simple circular wiring was the smallest and FEWS was better than the figure-eight wiring or the screw. There was no statistically significant difference between FEWS and Kirschner tension band at transverse and oblique fracture model （ P 〉 0. 05 ） , but FECW was superior to Kirschner tension band at comminuted fracture model （ P 〈 0. 05 ）. Twenty-six patients of olecranon fracture were treated with FECW and were followed up with an average period of 12 months. Complete bony healing was found in all patients and 92.30% of the patients had excellent or good result. [ Conclusion] Because of its reliable fixation,simplicity to insert and less damages, FECW is the ideal choice of the internal fixation for the olecranon fracture,especially for comminuted fracture.

关 键 词：钢丝环形加“8”字 尺骨鹰嘴骨折 内固定 生物力学 

分 类 号：R687.1[医药卫生—骨科学]