解剖锁定接骨板与克氏针张力带内固定治疗尺骨鹰嘴骨折的疗效比较  

Comparison of clinical effect between locking proximal plate and tension-band wire in treatment of olecranal fractures

作　　者：路遥[1] 韩康 王谦[1] 马腾[1] 孙亮[1] 卢代刚[1] 李明[1] 任程[1] 薛汉中[1] 段宁[1] 李忠[1] 张堃[1] LU Yao;WANG Qian;MA Teng;SUN Liang;LU Daigang;LI Ming;REN Cheng;XUE Hanzhong;DUAN Ning;LI Zhong;ZHANG Kun(Department of Orthopaedic Trauma,Honghui Hospital,Xi’an Jiaotong University,Xi'an,Shaanxi 710054,China;不详)

机构地区：[1]西安交通大学附属红会医院创伤骨科,陕西西安710054 [2]解放军第960医院脊髓修复科

出　　处：《中国骨与关节损伤杂志》2020年第7期697-699,共3页Chinese Journal of Bone and Joint Injury

基　　金：陕西省自然科学基金(2019JQ-976)。

摘　　要：目的比较解剖锁定接骨板与克氏针张力带内固定治疗尺骨鹰嘴骨折的临床疗效。方法回顾性分析自2013-01—2017-01采用内固定手术治疗的78例尺骨鹰嘴骨折,42例术中使用克氏针张力带固定(张力带组),36例术中使用解剖锁定接骨板固定(接骨板组),比较2组手术时间、术中出血量、切口大小、并发症情况、骨折愈合时间以及末次随访时MES评分、肘关节屈曲范围、伸直范围、前臂旋转范围。结果 78例均顺利完成手术并获得完整随访,随访时间平均21(12~48)个月。张力带组手术时间较接骨板组少,术中出血量较接骨板组少,手术切口较接骨板组小,差异有统计学意义(P <0.05)。2组骨折愈合时间比较差异无统计学意义(P>0.05)。张力带组出现4例内固定松动,6例软组织刺激,接骨板组出现1例切口感染,1例软组织刺激,接骨板组术后并发症较张力带组少,差异有统计学意义(P <0.05)。末次随访时2组MES评分、肘关节屈曲范围、伸直范围、前臂旋转范围比较差异无统计学意义(P>0.05)。结论解剖锁定接骨板与克氏针张力带内固定治疗尺骨鹰嘴骨折均能取得满意疗效,解剖锁定接骨板内固定术后并发症较少。Objective To compare the clinical effect between locking proximal plate and tension-band wire in treatment of olecranal fractures. Methods Seventy-eight patients with olecranal fractures treated with operations between January 2013 and January 2017 were analyzed retrospectively, 42 cases underwent tension bend(tension bend group), 36 cases received locking locking humeral plate(locking plate group). The operation time, intraoperative blood loss, incision size, complications,fracture healing time, MES score, elbow flexion range, extension range, and forearm rotation range were compared between the two groups. Results All 78 patients successfully completed the operation and received complete follow-up, with an average follow-up time of 21(12-48) months. The operation time of the tension band group was shorter than that of the locking humeral plate group, the intraoperative blood loss of the tension band group was less than of the locking humeral plate group,and the surgical incision of tension bend group was smaller than of the locking humeral plate group. The differences were statistically significant(P <0.05). There was no significant difference in fracture healing time between the two groups(P >0.05).In the tension band group, there were 4 cases of internal fixation loosening and 6 cases of soft tissue stimulation while in the locking humeral plate group there was one case of incision infection and 1 case of soft tissue stimulation. The postoperative complications of the proximal humeral plate group were less than of the tension band group, and the difference was statistically significant(P <0.05). There was no significant difference in MES score, elbow flexion range, extension range, and forearm rotation range at the last follow-up(P >0.05). Conclusion Both locking proximal plate and tension-band wire can be applied to treat olecranal fracture and humeral plate has less complications.

关 键 词：尺骨鹰嘴骨折 克氏针张力带 解剖锁定接骨板 内固定 

分 类 号：R687.3[医药卫生—骨科学]