尺骨鹰嘴骨折的内固定选择及临床疗效对比  

Choice of internal fixation selection and clinical effect of olecranon fracture

作　　者：张骏 陈定爽 刘东旭 李峰 ZHANG Jun;CHEN Ding-shuang;LIU Dong-xu;LI Feng(Department of Orthopaedics,Wenzhou Traditional Chinese and Western Medicine Hospital,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中西医结合医院骨科,浙江温州325000

出　　处：《中国骨伤》2020年第7期602-608,共7页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较普通克氏针、解剖型锁定钢板及预断式带孔克氏针治疗尺骨鹰嘴骨折的临床疗效。方法:对2014年3月至2017年5月采用不同内固定治疗的79例成人尺骨鹰嘴骨折患者的临床资料进行回顾性分析。其中普通克氏针固定(A组)26例,男19例,女7例;年龄23~51(37.2±9.6)岁;Mayo分型Ⅰ型11例,Ⅱ型15例。尺骨鹰嘴解剖型钢板固定(B组)28例,男16例,女12例;年龄25~52(36.6±8.9)岁;Mayo分型Ⅰ型10例,Ⅱ型18例。预断式带孔克氏针固定(C组)25例,男13例,女12例;年龄26~51(38.2±9.2)岁;Mayo分型Ⅰ型9例,Ⅱ型16例。比较3组患者的手术时间、术中出血量、骨折愈合时间及术后并发症情况,术后1周采用视觉模拟疼痛评分(visual analogue scale,VAS)评分评价疼痛缓解程度,末次随访时采用肘关节Broberg-Morrey功能评分进行疗效评价。结果:79例患者均获得随访,时间13~23(18.3±4.5)个月。A组手术时间、术中出血量、骨折愈合时间分别为(82.9±19.7)min,(113.5±32.3)ml,(4.2±0.6)个月;B组分别为(101.2±24.5)min,(150.2±39.5)ml,(4.6±0.8)个月;C组分别为(83.3±18.7)min,(119.3±34.3)ml,(4.1±0.5)个月;A、C组手术时间、术中出血量、骨折愈合时间均优于B组(P<0.05)。A组5例发生内固定失效,其他两组未发生;A组9例出现皮肤激惹,B组3例,C组未发生;3组并发症比较差异有统计学意义(P<0.05)。术后1周3组VAS评分和末次随访时3组肘关节Broberg-Morrey功能评分比较差异无统计学意义(P>0.05)。结论:普通克氏针术后并发症较多;解剖型钢板手术创伤较大,骨折愈合时间长;而预断式带孔克氏针不仅手术创伤小,有助于骨折愈合,且术后并发症相对较少,对于尺骨鹰嘴患者可考虑此种内固定治疗。Objective:To compare clinical effects of common Kirschner wire,anatomical plate and perforated Kirschner wire in treating olecranon fracture.Methods:From March 2014 to May 2017,clinical data of 79 patients with olecranon fracture treated with different internal fixation was retrospectively analyzed.Among them,26 patients treated with common Kirschner wire(group A),including 19 males and 7 females aged from 23 to 51 years old with an average of(37.2±9.6)years old;11 patients were typeⅠ,and 15 patients were typeⅡaccording to Mayo classification.Twenty-eight patients were treated with olecroanon anatomical plate internal fixation,including 16 males and 12 females aged from 25 to 52 years old with an average of(36.6±8.9)years old;10 patients were typeⅠand 18 patients were typeⅡaccording to Mayo classification.Twenty-five patients were treated with perforated Kirschner wire,including 13 males and 12 females aged from 26 to 51 years old with an average of(38.2±9.2)years old;9 patients were typeⅠand 16 patients were typeⅡaccording to Mayo classification.Operation time,intraoperatve blood loss,fracture healing time and postoperative complications among three groups were compared;VAS score at 1 week after operation was used to evaluate pain relief,Broberg-Morrey function score of elbow joint at the final follow-up was applied to evaluate clinical effect.Results:Seventy-nine patients were followed up from 13 to 23 months with an average of(18.3±4.5)months.Operation time,intraoperatve blood loss,fracture healing time in group A were(82.9±19.7)min,(113.5±32.3)ml,(4.2±0.6)months respectively;in group B were(101.2±24.5)min,(150.2±39.5)ml,(4.6±0.8)months respectively;in group C were(83.3±18.7)min,(119.3±34.3)ml,(4.1±0.5)months respectively.Operation time,intraoperatve blood loss,fracture healing time in group A and group C were better than that of group B(P<0.05).Five patients in group A occurred ineffective internal fixation,other groups did not occurred;9 patients in group A occurred skin irritability

关 键 词：肘关节 尺骨 骨折固定术 内 

分 类 号：R683.41[医药卫生—骨科学]