星状钢板治疗尺骨鹰嘴撕脱骨折疗效观察  

CLINICAL OBSERVATION OF STELLATED PLATE FIXATION OF OLECRANAL AVULSION FRACTURE

作　　者：宫先斌[1,2] 舒衡生[2] 王宏川[2] 赵嘉国[2] 李卫哲[2] 石博文[2] 梁勇健[1,3] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津医院创伤骨料 [3]武警后勤学院

出　　处：《中国修复重建外科杂志》2014年第4期410-413,共4页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨星状钢板治疗尺骨鹰嘴撕脱骨折的临床疗效。方法回顾分析2007年4月-2012年4月,采用星状钢板治疗的24例尺骨鹰嘴撕脱骨折患者临床资料。男13例,女11例;年龄18~65岁,平均32岁。致伤原因:摔伤14例,运动伤7例,机器伤3例。左侧4例,右侧20例。病程3 h^2 d,平均11 h。骨折根据Colton分型标准,均为ⅡA型(撕脱骨折)。合并肱骨内上髁撕脱骨折1例,肱三头肌肌腱撕裂15例。结果术后切口均Ⅰ期愈合,无感染及尺神经损伤等并发症发生。患者均获随访,随访时间18~48个月,平均24个月。X线片复查示,所有骨折均达骨性愈合,愈合时间6~10周,平均7周。术后1年,按照Morrey肘关节功能评定标准,获优17例,良4例,可3例,优良率87.5%;患侧肘关节活动度为(136.0±16.2)°,与健侧(143.1±2.9)°比较差异无统计学意义(t=2.007,P=0.052)。其中Morrey评分为优、良者术后患侧肘关节活动度与健侧比较差异无统计学意义(P>0.05);为可者患侧显著低于健侧,差异有统计学意义(t=2.820,P=0.048)。结论星状钢板依其独特的齿轮结构设计,可有效固定尺骨鹰嘴撕脱骨折,具有操作简便、固定牢固、有利于患者早期功能锻炼等优点,可获得较好疗效。Objective To evaluate the clinical outcome of stellated plate fixation of olecranal avulsion fracture. Methods A retrospective analysis was made on the clinical data from 24 cases of olecranal avulsion fracture treated with stellated plate between April 2007 and April 2012. There were 13 males and 11 females, with an average age of 32 years （range, 18- 65 years）. The causes of injury included falling injury （14 cases）, sports injury （7 cases）, and machine injury （3 cases）. The left elbow was involved in 4 cases and the right side in 20 cases. The average disease duration was 11 hours （range, 3 hours-2 days）. According to Colton＇s classification criteria, all cases were classified as type II A （axadsion fracture）. One case had supracondylar humeral avulsion fracture, and 15 cases had triceps tendon tears. Results All the cases obtained healing of incision by first intention, without infection and ulnar nerve injury. The average follow-up period was 24 months （range, 18-48 months）. All fractures healed after 6-10 weeks （mean, 7 weeks）. According to Morrey＇s elbow performance score, the results were excellent in 17 cases, good in 4 cases, and fair in 3 cases, with an excellent and good rate of 87.5%. There was no significant difference in the elbow range of motion （ROM） between the injured side （136.0 ±16.2）° and normal side （143.1±2.9）° （t=2.007, P=0.052）. The ROM of normal elbow was significantly larger than that of the injured side in 3 patients who achieved fair results （t=-2.820, P=0.048）, but no significant difference was found in patients who achieved excellent and good results （P 〉 0.05）. Conclusion The stellated plate has good clinical outcome in treatment of olecranal avulsion fracture, which has advantages of simple operation, firm fixation, and early functional exercise.

关 键 词：尺骨鹰嘴撕脱骨折 星状钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]