楔形截骨联合内固定治疗MayoⅡB型尺骨鹰嘴骨折  

Wedge osteotomy combined with internal fixation for ulnar olecranon fracture of Mayo type ⅡB

作　　者：拾坤[1] 赵猛[1] 夏计划[1] 姜效韦[1] 戴维享[1] 马超[1] 李杰[1] 王兆红[1] Shi Kun;Zhao Meng;Xia Jihua;Jiang Xiaowei;Dai Weixiang;Ma Chao;Li Jie;Wang Zhaohong(Department of Spinal Surgery,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China)

机构地区：[1]徐州市中心医院骨脊柱外科,221009

出　　处：《中华创伤骨科杂志》2019年第1期73-76,共4页Chinese Journal of Orthopaedic Trauma

基　　金：徐州市科技情报所研究计划项目(XKQ046).

摘　　要：目的探讨尺骨鹰嘴楔形截骨联合内固定治疗MayoⅡB型尺骨鹰嘴骨折的临床疗效和截骨安全范围。方法回顾性分析2014年7月至2017年12月徐州市中心医院骨脊柱外科收治的8例MayoⅡB型尺骨鹰嘴骨折患者资料。男6例,女2例;年龄28~45岁,平均31.4岁。所有患者均使用尺骨鹰嘴楔形截骨结合内固定治疗,术前根据文献制定截骨方案,术后测量截骨长度以验证截骨安全范围,复查X线评价骨折愈合情况并评估肘关节活动度及功能。结果8例患者尺骨鹰嘴关节面截骨平均6.2mm,鹰嘴基底部截骨平均14.5mm,术后尺骨鹰嘴短缩平均4.6mm。术后8例患者均获随访,随访时间14~20个月,平均16.4个月。骨临床愈合时间为12~16周,平均14.3周。随访期间无骨折移位、疼痛及内固定失效等并发症的发生。术后3个月、1年患侧肘关节屈曲、伸直及活动范围与健侧相比,差异均无统计学意义(P>0.05)。术后3个月按Broberg-Morry评估标准评定疗效:优5例,良2例,可1例。末次随访时无关节不稳及创伤性关节炎的发生。结论楔形截骨联合内固定治疗MayoⅡB型尺骨鹰嘴骨折中期效果良好,本组患者尺骨鹰嘴楔形截骨长度安全,为尺骨鹰嘴MayoⅡB型骨折的治疗提供了新的思路。ObjectiveTo investigate the clinical efficacy and safety of wedge osteotomy combined with internal fixation for ulnar olecranon fracture of Mayo type ⅡB.MethodsFrom July 2014 to December 2017, 8 patients with ulnar olecranon fracture of Mayo type ⅡB were treated with wedge osteotomy of the ulnar olecranon combined with internal fixation. They were 6 men and 2 women, from 28 to 45 years of age (mean, 31.4 years). The wedge osteotomy was planned preoperatively according to the literature data and the osteotomy lengths were measured postoperatively to confirm the safe range for the surgery. Fracture healing was evaluated by regular X-ray follow-up and therapeutic effects were assessed by the range of elbow motion and the Broberg-Morry scoring system.ResultsOn average in this group, the olecranon osteotomy was 6.2 mm in length on the articular surface and 14.5 mm at the basal part. The olecranon was shortened by 4.6 cm on av-erage after operation. All the 8 patients were followed up for 14 to 20 months (average, 16.4 months). The clinical fracture healing time ranged from 12 to 16 weeks, with an average of 14.3 weeks. Follow-ups revealed no fracture displacement, pain or internal fixation failure. No significant differences were found between the affected and the contralateral sides in the flexion, extension or range of motion of the elbow joint at 3 months or at one year after surgery (P>0.05). According to the Broberg-Morry scoring system, 5 cases were rated as excellent, 2 as good and one as fair at 3 months after surgery. The final follow-ups found no traumatic arthritis or joint instability.ConclusionsAs a new treatment alternative, wedge osteotomy combined with internal fixation can obtain satisfactory curative outcomes for ulnar olecranon fractures of Mayo type ⅡB. The wedge osteotomy was performed in a safe range for this group.

关 键 词：尺骨骨折 骨折固定术 内 肘关节 楔形截骨 

分 类 号：R687.3[医药卫生—骨科学]