不同类型尺骨近端骨折的内固定选择和疗效分析  

Implants options and efficacy analysis of proximal ulna fractures in different types

作　　者：宋哲 杨娜 王晨 衡立松 樊伟 朱养均 张堃 Song Zhe;YangNa;Wang Chen;Heng Lisong;Fan Wei;Zhu Yangjun;Zhang Kun(Department of Orthopaedic Trauma,Honghui Hospital,Xi’an Jiaotong University College of Medicine,Xi’an 710054,China)

机构地区：[1]西安市红会医院创伤骨科

出　　处：《中华肩肘外科电子杂志》2019年第4期342-347,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：陕西省社会发展科技攻关项目(2017SF197)

摘　　要：目的探讨不同类型尺骨近端骨折的临床特点、内固定选择、手术策略和临床疗效。方法回顾性分析2014年6月至2017年6月收治的45例尺骨近端骨折患者资料,男26例、女19例;年龄19~65岁,平均40.8岁;致伤原因:摔伤25例,高处坠落伤12例,交通伤8例。所有患者均行手术治疗,根据骨折的特点和类型分别选择克氏针张力带、解剖钢板或两者联合的方法固定骨折,恢复骨性结构的稳定性。合并尺骨冠状突骨折采用袢钢板固定。合并桡骨头骨折采用微型钢板固定或金属桡骨头置换。合并韧带损伤时均采用带线锚钉缝合固定修补。结果45例患者获15.6个月(12~24个月)随访。随访结果:所有患者均获骨性愈合,愈合时间平均为11.2周(8~16周)。末次随访:肘部屈曲活动80°~135°,平均121°;肘部伸直活动0~30°,平均8°。Mayo肘关节功能评分为50~100分,平均88.2分,其中优26例,良15例,可2例,差2例,优良率为91.1%。结论尺骨近端骨折形态各异,应该根据受伤机制、骨折特点及患者情况进行骨折严重程度的评估和分型,选择合理的内固定方式,积极进行术后康复,恢复良好的肘关节功能。Background The proximal ulna includes the ulnar olecranon and part of the proximal ulna,which is mainly composed of olecranon fractures,which are common elbow injuries in adults,accounting for 10%of all upper limb fractures,which can be caused by direct or indirect violence.Because the olecranon fracture is an intra-articular fracture,except for a small number of reports that use non-surgical treatment,most doctors believe that surgery is needed to restore the normal articular surface and the shape of the pulley in order to achieve predictable results.In recent years,there are some controversies in the treatment methods and intraoperative fixation of proximal ulnar fractures.Currently,the most commonly used methods in clinical practice are tension band technique and plate internal fixation technology,but each technique has its own indications,advantages and disadvantages.This study retrospectively analyzed 45 patients with proximal ulnar fractures who underwent surgery in our department from June 2014 to June 2017.The purpose of this study was to investigate the clinical features of different types of proximal ulnar fractures,internal fixation options,surgical strategies and clinical efficacy.Methods I.Inclusion and exclusion criteria.Inclusion criteria:(1)fractures involve proximal ulnar.(2)fresh fractures.(3)without vascular and/or nerve injury.(4)closed fractures.(5)without serious medical diseases.(6)follow-up time≥12 months.Exclusion criteria:(1)fractures do not involve proximal ulnar.(2)old fracture.(3)with vascular and/or nerve injury.(4)with open fractures.(5)can not tolerate the operation.(6)follow-up time<12 months or lost to follow-up.Ⅱ.General information.In this study,45 patients with proximal ulnar fractures were included.Including 26 males and 19 females;aged 19-65 years,mean 40.8 years;18 cases on the left and 27 on the right.45 patients were all closed injuries,and 13 patients had proximal humeral and elbow ligament injuries.Causes of injury:25 cases of falls,12 cases of fall from height,and

关 键 词：尺骨 近端 骨折固定术 临床疗效 

分 类 号：R68[医药卫生—骨科学]