肱三头肌腱尺骨鹰嘴止点断裂的临床特征  

Clinical characteristics of triceps brachii tendon rupture at olecranon ending

作　　者：马江涛 毛玉江[2] 俞敏 俞高峰 竺丛庆 张孟超 

机构地区：[1]新昌县张氏骨伤医院骨科,浙江新昌312500 [2]积水潭医院创伤骨科,北京100035

出　　处：《中国骨伤》2014年第11期957-960,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：观察肱三头肌腱尺骨鹰嘴止点断裂的临床特征。方法 ：自2005年6月至2011年11月,共收治肱三头肌腱尺骨鹰嘴止点断裂19例,男7例,年龄15~41岁,平均24.1岁;女12例,年龄16~73岁,平均51.4岁。左侧8例,右侧11例。行走跌伤17例,高处坠落伤2例。单纯肱三头肌腱尺骨鹰嘴止点断裂13例,合并其他肘部损伤6例。合并桡骨头骨折5例,肱骨小头骨折1例,尺骨冠状突骨折1例,肱骨内上髁骨折1例。所有病例在肘关节侧位X线片上显示＂骨片征＂,合并伤有相应表现。均予手术治疗：＂8＂字钢丝固定15例,＂8＂字钢丝加克氏针固定1例,钢丝环扎固定1例,不吸收线缝合2例。合并伤予相应处理。除2例合并伤较重患者术后石膏固定4周,其余病例未行外固定。术后随访采用Mayo肘关节评分评价肘关节功能。结果：19例术后均获随访,1例术后1年死于其他疾病,其余18例随访时间14~91个月,平均47.9个月。Mayo肘关节评分优16例,良2例。结论：肱三头肌腱尺骨鹰嘴止点断裂临床上并不少见,好发于50岁以上女性和30以下男性,手术治疗效果良好,但合并有其他肘部损伤患者常遗留不同程度功能障碍。Objective：To observe the clinical characteristics of triceps brachii tendon rupture at olecranon ending. Methods：From June 2005 to November 2011,19 patients with triceps brachii tendon rupture at olecranon ending were treated with surgical technique. Among the 19 patients,7 patients were male,with an average age of 24.1 years old（ranged,15 to 41 years old）; 12 patients were female,with an average age of 51.4 years old（ranged,16 to 73 years old）. Eight patients had injuries in the left elbows,and 11 patients had injuries in right elbows. Seventeen patients had injuries induced by walking fall and 2 patients had injuries induced by falling down. Thirteen patients were simple triceps brachii tendon rupture at olecranon ending,6patients were associated with other elbow injuries. Five patients were associated with radial fracture;1 patient with capitellum fracture;1 patient with coronoid process fracture;1 patient with epitrochlear. All the lateral radiographs of the injuried elbow demenstrated the flecks of avulsed osseous material from the olecranon（flake sign）. The associated injuries had the homologus presence. All the patients were treated with surgical techniques ：15 patients were treated with figure of eight tension band wire;figure of eight tension band wire and Kirschner wire in 1 patient;wire cerclage in 1 patient; nonabsorbable suture in 2patients. The associated injuries were treated simultaneously. Plaster was applied after operation in 2 patients with heavier elbow associated injuries,other patients without any external fixation. The Mayo elbow score were observed to determinate the function of the elbow. Results：All the patients were followed up,1 patient died of other disease at one year after operation,the other 18 patients were followed up with an average of 47.9 months（ranged from 14 to 91 months）. According to the Mayo elbow score,16 patients got an excellent result and 2 good. Conclusion：Traumatic rupture of triceps brachii tendon at olecranon ending is not a rare injury,

关 键 词：肘关节 骨折固定术 创伤和损伤 

分 类 号：R726.834.1[医药卫生—儿科]