应用张力带钢丝和钢板内固定治疗儿童尺骨鹰嘴骨折的效果评价  

Comparative evaluation of tensile band wire treatment and plate fixation treatment of children with olecroanon fracture

作　　者：李毅力[1] 刘星[1] 李明[1] 刘传康[1] 罗聪[1] 瞿向阳[1] 

机构地区：[1]重庆医科大学附属儿童医院骨科,儿童发育疾病研究教育部重点实验室,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,400014

出　　处：《中华实用儿科临床杂志》2016年第10期795-797,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家临床重点专科建设项目资助[国卫办医函（2013）544];重庆市卫计委重点项目资助[渝卫科教（2013）39号2013-10-29]

摘　　要：目的比较张力带钢丝和钢板内固定在治疗儿童尺骨鹰嘴骨折的临床效果。方法回顾性分析重庆医科大学附属儿童医院2006年1月至2014年1月治疗的63例单纯儿童尺骨鹰嘴骨折临床资料，其中按照内固定方法分为张力带钢丝组41例，解剖钢板内固定组（钢板组）22例。分别对手术时间、术中出血量、术后骨折恢复时间、术后并发症及关节功能的恢复情况进行统计学分析。结果张力带钢丝内固定无克氏针松动、无骨折移位，钢板组出现2例骨化性肌炎，但均无骨不连发生；钢板组手术时间为（65．3±8．4）min，张力带钢丝组手术时间为（58．4±12．6）min，2组比较差异有统计学意义（t=7．419，P〈0．05）；术中出血量：钢板内固定治疗组（5．3±0．8）mL，张力带钢丝组（4．7±1．2）mL，2组比较差异有统计学意义（t=2．595，P〈0．05）；骨折愈合时间：钢板组（74．1±8．4）d，张力带钢丝组（61．7±9．3）d，2组比较差异有统计学意义（t=10。636，P〈0．05）；2组患儿采用肘关节功能评定方法评估功能恢复：张力带钢丝组优良率为85．3％（35／41例），钢板组优良率为81．8％（17／22例），2组比较差异无统计学意义（X2=0．651，P〉0．05）。结论儿童尺骨鹰嘴骨折采用张力带钢丝固定可能是一种较好的固定方式，更适合在基层医院开展使用。Objective To compare the clinical effect of tensile band wire fixation and plate fixation for trea- ting children with olecroanon fracture. Methods Sixty - three children with olecroanon fracture at Children＇s Hospital of Chongqing Medical University from January 2006 to January 2014 were selected. In those cases of fracture by means of open reduction,41 cases were treated with tensile band wire, and 22 cases were treated with internal fixation with an- atomical plate. Operation time, bleeding during operation, recovery time postoperatively, postoperative complications and joint function recovery were analyzed by using independent sample t - test and chi - square test. Results In the group of tensile band wire ,there was no case of Kirschner wire loosening and displacement fracture. In group of steel plate, there were 2 cases of myositis ossificans. In the 2 groups, there was no case of bone nonunion. The average operation time：plate fixation group was （65.3 ± 8.4 ） min and tension band wire group was （58.4 ±12.6 ） min, and there was a significant difference between the both groups （ t = 7. 419, P 〈 0.05 ） ; blood loss ： plate fixation group was （ 5.3± 0.8 ） mL and tension band wire group was （4.7±1.2 ） mL, and there was a significant difference between the both groups （t = 2. 595 ,P 〈 0.05 ）;fracture healing time：plate fixation group was （ 74. 1± 8.4 ） d and tension band wire group was （61.7 ± 9.3 ） d, and there was a significant difference between the both groups （t = 10. 636, P 〈 0.05 ）. With Broberg -Morrey to evaluate two groups＇quality rate of function recovery, there was no significant difference in sta- tistics with 85.3% （35/41 cases） in tensile band wire group and 81.8% （17/22 cases） in steel plate grouP（X2 = 0.651 ,P 〉 0.05 ）. Conclusions Olecranon fracture in children using tension band wire fixation may be a better way, more suitable for promotion and implementation at basic hospital.

关 键 词：尺骨鹰嘴骨折 张力带钢丝 钢板内固定 JL童 

分 类 号：R726.8[医药卫生—儿科]