双微型锁定钢板与解剖型锁定钢板治疗尺骨鹰嘴粉碎性骨折的疗效比较  

Comparison of double mini locking plate and anatomical locking plate in the treatment of comminuted olecranon fracture

作　　者：姬帅 马腾[2] 王谦[2] 路遥[2] 李明[2] 任程[2] 戚鸿飞 崔玉 杜兵[1,2] 杨彦玲 张堃[2] 李忠[2] Ji Shuai;Ma Teng;Wang Qian;Lu Yao;Li Ming;Ren Cheng;Qi Hongfei;Cui Yu;Du Bing;Yang Yanling;Zhang Kun;Li Zhong(Yan′an University,Yan′an 716000,China;Department of Orthopedic Trauma,Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University,Xi′an 710054,China)

机构地区：[1]延安大学,延安716000 [2]西安交通大学附属红会医院创伤骨科,西安710054

出　　处：《国际外科学杂志》2022年第7期442-447,共6页International Journal of Surgery

基　　金：陕西省自然科学基金(2022JQ-299);西安市卫生健康委员会科研项目(2021yb26)。

摘　　要：目的比较双微型锁定钢板与解剖型锁定钢板治疗尺骨鹰嘴粉碎性骨折的疗效。方法采用回顾性病例对照研究的方法分析2017年3月—2020年5月西安交通大学附属红会医院收治的46例接受手术治疗的鹰嘴粉碎性骨折患者的临床数据, 根据手术方法不同分为两组, 其中21例接受双微型锁定钢板治疗(双钢板组), 25例接受解剖型锁定钢板治疗(单钢板组)。比较两种固定方法的手术时间、患者满意度、最终活动度、返回工作时间、软组织刺激取出内固定、Mayo肘关节功能评分(MEPS)、手臂、肩部和手残疾评分(DASH)。正态分布的计量资料以均数±标准差(±s)表示, 组间比较采用t检验;计数资料组间比较采用χ~2检验或Fisher确切概率法。结果 46例患者术后均获得随访, 时间为(19.17±2.79)个月, 术后所有骨折获得骨性愈合, 两组患者在手术时间、活动度、患者满意度、MEPS和DASH评分方面差异无统计学意义(P>0.05);双钢板组返回工作时间为(8.47±2.13)周, 单钢板组返回工作时间为(9.78±1.98)周, 两组相比差异有统计学意义(P<0.05);因软组织刺激需取出内固定9例, 双钢板组1例, 单钢板组8例, 两组相比差异有统计学意义(P<0.05)。结论与解剖型锁定钢板相比, 采用双微型锁定钢板治疗尺骨鹰嘴骨折可以有效减轻软组织刺激, 促进患者早期返回工作岗位, 且手术时间并没有显著延长, 生物力学优势明显, 临床效果满意, 术后功能恢复良好, 是一种有效的治疗方式。Objective To compare the efficacy of double mini locking plate and anatomical locking plate in the treatment of comminuted olecranon fracture.Methods The clinical data of 46 patients who underwent comminuted olecranon fracture in the Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2017 to May 2020 were analyzed retrospectively.Among them,21 cases were treated with double mini locking plate(double plate group)and 25 cases with anatomical locking plate(single plate group).The operation time,patient satisfaction,range of motion,return to work time,soft tissue stimulation to remove internal fixation,Mayo elbow performance score(MEPS),disabilities of arm,shoulder and hand score(DASH)of the two fixation methods were statistically compared.Measurement data with normal distribution were represented as(±s),and comparison between groups was conducted using the t test.Comparison between groups of count data was conducted using the chi-square test or Fisher exact probability.Results All 46 patients were followed up for to(19.17±2.79)months.All fractures healed after operation.There was no significant difference in operation time,range of motion,patient satisfaction,MEPS and DASH scores among the two groups(P>0.05).The time of returning to work was(8.47±2.13)weeks in the double plate group and(9.78±1.98)weeks in the single plate group,and the difference was statistically significant(P<0.05).There were 9 cases of internal fixation due to soft tissue stimulation,1 cases in double plate group and 8 cases in single plate group,and the difference was statistically significant(P<0.05).Conclusions Compared with anatomical locking plate,the treatment of olecranon fracture with double mini locking plate can effectively reduce soft tissue stimulation and promote patients to return to work early,and the operation time is not significantly prolonged,and the biomechanical advantage is obvious,the clinical effect is satisfactory and the postoperative function is good,so it is an effective treatment.

关 键 词：骨折 回顾性研究 治疗结果 微型钢板 

分 类 号：R687.3[医药卫生—骨科学]